| NPI | 1023177029 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMY ELLIS Pharmacy Services Administrator 616-878-2848 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: MI 5301008215) |
| Enumeration Date | 2006-12-06 |
| Last Update Date | 2023-12-07 |