| NPI | 1730506510 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH MIRRO Cmo 269-382-2500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: MI 5301010374) |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2014-03-18 |
| Last Update Date | 2017-03-01 |