| NPI | 1346887866 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MAISA JAMIE HIDER Owner 313-889-8909 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336L0003X Pharmacy, Long Term Care Pharmacy |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2019-12-03 |
| Last Update Date | 2024-05-24 |