| NPI | 1568730745 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TASHA BLACKMON CEO 616-965-8215 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: MI 5301009686) |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2011-12-02 |
| Last Update Date | 2018-04-20 |