| NPI | 1518504091 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HUSSEIN CHAMMOUT Pharmacist In Charge 313-635-5234 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Enumeration Date | 2019-12-04 |
| Last Update Date | 2024-10-09 |