NPI | 1669227203 |
---|---|
Entity Type | Organization |
Authorized Contact | KIM JANE HINES Pharmacy Manager 231-492-4996 |
Organization Subpart ? | No |
Primary Taxonomy | 332800000X Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy |
Additional Taxonomies | 3336C0002X Pharmacy, Clinic Pharmacy |
Enumeration Date | 2024-04-18 |
Last Update Date | 2024-11-13 |