Tabetha M Long, RPH

NPI #1659665842 in Shiloh, Illinois

Provider Information

NPI Number: 1659665842
Entity Type: Individual
Name: Tabetha M Long, RPH
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Pharmacist
Credential: RPH
Enumeration Date: Jun 5, 2011
Last Updated: Jun 5, 2011

Practice Location

Address: 3400 GREEN MOUNT CROSSING DR
Address 2: T-1539
City: Shiloh
State: Illinois
ZIP Code: 62269-7277
Phone: (618) 628-3334

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pharmacist	183500000X	Primary

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