| NPI | 1447023999 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RELANDA PRICE Provider Enrollment Manger 517-884-2976 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 3336S0011X Pharmacy, Specialty Pharmacy |
| Enumeration Date | 2023-11-06 |
| Last Update Date | 2023-11-13 |