Most Relevant Information
Provider Data
| NPI Number: | 1003218090 |
| Provider Name: | SAM B AN PHARM.D. |
| Entity Type: | Individual |
| Taxonomy Code: | 183500000X |
| Specialty: | Pharmacist |
| License Number: | 051297279 |
Most Important Dates
| Enumeration Date: | 09/22/2014 |
| Last Updated: | 12/16/2019 |
Provider Practice Location
311 N WESTERN AVE
PEORIA
IL
616045638
Practice Location Phone/Fax
| Phone: | 3096766333 |
| Fax: | 3096761928 |
Provider Mailing Location
311 N WESTERN AVE
PEORIA
IL
616045638
Provider Mailing Phone/Fax
| Phone: | 3096766333 |
| Fax: | 3096761928 |