| NPI | 1356760730 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HENGAMEH KHALEDI President 248-757-2503 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: MI 5301010400) |
| Additional Taxonomies | 333600000X Pharmacy (Licence: MI 5301010400) |
| 3336S0011X Pharmacy, Specialty Pharmacy (Licence: MI 5301010400) | |
| 332B00000X Durable Medical Equipment & Medical Supplies (Licence: MI 5301010400) | |
| Enumeration Date | 2014-04-14 |
| Last Update Date | 2014-11-05 |