| NPI | 1649463712 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREW J MAC Pharmacist In Charge 734-744-4070 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336L0003X Pharmacy, Long Term Care Pharmacy (Licence: MI 5301008682) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| 333600000X Pharmacy | |
| 3336L0003X Pharmacy, Long Term Care Pharmacy | |
| Enumeration Date | 2007-08-22 |
| Last Update Date | 2023-02-09 |