NPI | 1467997239 |
---|---|
Doing Business As | LITTLE RIVER BAND OF OTTAWA INDIANS PHARMACY |
Entity Type | Organization |
Authorized Contact | KEITH JACQUE Chief Pharmacist 231-398-6853 |
Organization Subpart ? | No |
Primary Taxonomy | 332800000X Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy (Licence: MI 5301011115) |
Additional Taxonomies | 3336C0002X Pharmacy, Clinic Pharmacy (Licence: MI 5301011115) |
3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: MI 5301011115) | |
Enumeration Date | 2017-01-03 |
Last Update Date | 2022-12-04 |