| NPI | 1497030670 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WISSAM SALAME Manager 313-277-4546 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: MI 5301009658) |
| Additional Taxonomies | 333600000X Pharmacy (Licence: MI 5301009658) |
| 3336L0003X Pharmacy Long Term Care Pharmacy | |
| Enumeration Date | 2011-10-19 |
| Last Update Date | 2018-09-22 |