| NPI | 1275173841 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REBEKAH LYN DESARMO Executive Operations Administrator 231-652-7810 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 3336L0003X Pharmacy Long Term Care Pharmacy |
| Enumeration Date | 2020-01-13 |
| Last Update Date | 2023-03-07 |