| NPI | 1417005414 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KHAJSNDRANTH ATLURI Phcst 248-219-0160 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: MI 5301008565) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| 3336C0004X Pharmacy, Compounding Pharmacy | |
| Enumeration Date | 2007-01-08 |
| Last Update Date | 2007-10-04 |