| NPI | 1194253195 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KHODR M BAZZI Pharmacy Owner/Pharmacist In Charge 313-414-5507 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: MI 5301011186) |
| Enumeration Date | 2017-06-02 |
| Last Update Date | 2022-07-21 |