| NPI | 1588495659 |
|---|---|
| Doing Business As | PORTLAND PHARMACY INC LTC |
| Entity Type | Organization |
| Authorized Contact | MALIK AHMED SHAIBI Supervising Pharmacy 313-442-2400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336L0003X Pharmacy, Long Term Care Pharmacy |
| Enumeration Date | 2024-08-12 |
| Last Update Date | 2024-08-12 |