| NPI | 1376010223 |
|---|---|
| Doing Business As | GREAT LAKES BAY HEALTH CENTERS PHARMACY DAVENPORT |
| Entity Type | Organization |
| Authorized Contact | LISA GALONSKA Vice President 989-759-6464 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Enumeration Date | 2018-10-30 |
| Last Update Date | 2018-10-30 |