| NPI | 1629188339 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RUSS BOBLET Pharmacist/Owner 269-420-2990 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: MI 5301009157) |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2015-12-29 |