| NPI | 1588052492 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RUSS BOBLET Partner 269-420-2990 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: MI 5301010616) |
| Enumeration Date | 2014-12-30 |
| Last Update Date | 2022-04-20 |