| NPI | 1720171622 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHILIP GERARD THOM Director Of Operation 810-733-0280 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336M0002X Pharmacy, Mail Order Pharmacy |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2020-08-22 |