| NPI | 1003332271 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ASHLEY THURSTON Director Of Business Development 734-929-2160 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332900000X Non-Pharmacy Dispensing Site |
| Enumeration Date | 2017-08-18 |
| Last Update Date | 2022-07-21 |