| NPI | 1114012374 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREGORY JONAS Pharmacy Manager 517-336-5636 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: MI 5301004196) |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2020-08-22 |