| NPI | 1407076003 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEROME J. VAN GASSE President 734-663-3920 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336S0011X Pharmacy, Specialty Pharmacy (Licence: MI 5306000305) |
| Enumeration Date | 2007-04-26 |
| Last Update Date | 2020-08-22 |