| NPI | 1154969517 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALI KASSEM NASSER Manager 313-485-1411 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Additional Taxonomies | 3336S0011X Pharmacy, Specialty Pharmacy |
| Enumeration Date | 2019-12-17 |
| Last Update Date | 2022-03-16 |