| NPI | 1053642041 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EYAD KHADR Owner 810-588-0000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: MI 5301009280) |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment (Licence: MI 5301009280) |
| 332BD1200X Durable Medical Equipment & Medical Supplies, Dialysis Equipment & Supplies | |
| Enumeration Date | 2010-01-15 |
| Last Update Date | 2015-03-23 |