| NPI | 1376655365 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDWARD NANTAIS Owner Phcst 269-668-4549 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Additional Taxonomies | 333600000X Pharmacy (Licence: MI 5301005559) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2008-07-24 |