| NPI | 1477603777 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON BEAUCH Director Of Pharmacy Managed Care 616-791-3169 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: MI 5301006977) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: MI 5301006977) |
| Enumeration Date | 2007-01-11 |
| Last Update Date | 2014-03-24 |