| NPI | 1487793436 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARLTON BOSSE Director Of Pharmacy 231-728-5974 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: MI 5301008544) |
| Additional Taxonomies | 3336C0004X Pharmacy, Compounding Pharmacy |
| 3336I0012X Pharmacy, Institutional Pharmacy | |
| Enumeration Date | 2007-02-06 |
| Last Update Date | 2008-02-22 |