| NPI | 1588108260 |
|---|---|
| Doing Business As | LTBB OF ODAWA PHARMACY |
| Entity Type | Organization |
| Authorized Contact | PHIL HARMON Direct Services Administrator 231-242-1421 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332800000X Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy |
| Enumeration Date | 2016-12-14 |
| Last Update Date | 2022-07-21 |