| NPI | 1447734496 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MOHAMMED FAWAZ Owner/Agent 734-961-8885 |
| Organization Subpart ? | No |
| Primary Taxonomy | 183500000X Pharmacist |
| Additional Taxonomies | 3336C0003X Pharmacy Community/Retail Pharmacy |
| Enumeration Date | 2018-09-16 |
| Last Update Date | 2019-07-17 |