| NPI | 1376040659 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRYAN CROSS COO 989-839-1322 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy (Licence: MI 5301011043) |
| Additional Taxonomies | 3336I0012X Pharmacy, Institutional Pharmacy (Licence: MI 5301011043) |
| Enumeration Date | 2018-04-12 |
| Last Update Date | 2022-05-20 |