| NPI | 1679010763 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANNE MARIE ANGE Pharmacist In Charge/ Managing Empl 586-315-1200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy (Licence: MI 5301011132) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| 3336C0003X Pharmacy, Community/Retail Pharmacy | |
| Enumeration Date | 2017-01-26 |
| Last Update Date | 2018-08-28 |