| NPI | 1194262568 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BASSAM YOUSSEF Owner 810-732-4449 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0004X Pharmacy, Compounding Pharmacy (Licence: MI 5301011022) |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2017-01-24 |
| Last Update Date | 2017-02-14 |