| NPI | 1619832763 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ISSA KAKISH Pharmacist In Charge 586-216-1023 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Enumeration Date | 2025-12-22 |
| Last Update Date | 2026-05-18 |