| NPI | 1023031002 |
|---|---|
| Doing Business As | GREAT LAKES PHARMACY |
| Entity Type | Organization |
| Authorized Contact | MATTHEW PIERCE Owner 734-729-5253 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336L0003X Pharmacy, Long Term Care Pharmacy |
| Additional Taxonomies | 333600000X Pharmacy (Licence: MI 5301008307) |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2008-06-17 |