| NPI | 1295372118 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HALA BAZZI-LANG Pharmacist 313-805-2444 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2019-12-10 |
| Last Update Date | 2020-06-04 |