| NPI | 1508253485 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EMILY RAHEMI Office Manager 269-501-7034 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Additional Taxonomies | 3336C0004X Pharmacy, Compounding Pharmacy |
| Enumeration Date | 2015-04-18 |
| Last Update Date | 2015-04-18 |