| NPI | 1437678141 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISHNA KANDAGATLA Owner 517-992-5101 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336L0003X Pharmacy Long Term Care Pharmacy |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2017-09-13 |
| Last Update Date | 2023-11-14 |