| NPI | 1720072812 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN G KOLFAGE President 313-277-2160 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332100000X Department of Veterans Affairs (VA) Pharmacy (Licence: MI 5306000370) |
| Additional Taxonomies | 332BX2000X Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies |
| Enumeration Date | 2005-09-06 |
| Last Update Date | 2012-01-12 |