| NPI | 1013394378 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PIERRE BOUTROS Pharmacy Director 248-361-6868 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336L0003X Pharmacy Long Term Care Pharmacy (Licence: MI 5301010707) |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2015-05-06 |
| Last Update Date | 2018-07-19 |