| NPI | 1316220155 |
|---|---|
| Doing Business As | IDM PHARMACY |
| Entity Type | Organization |
| Authorized Contact | FAUSTINA IROHA CEO 248-943-1123 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: MI 5315052908) |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2011-09-27 |
| Last Update Date | 2016-12-13 |