| NPI | 1679790943 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARLTON BOSSE Director Of Pharmacy 231-728-5974 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: MI 5301005826) |
| Enumeration Date | 2007-04-19 |
| Last Update Date | 2020-08-22 |