| NPI | 1730819574 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REBEKAH LYN DESARMO VP Of Finance 231-861-6902 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336I0012X Pharmacy Institutional Pharmacy |
| Additional Taxonomies | 333600000X Pharmacy |
| 3336C0003X Pharmacy Community/Retail Pharmacy | |
| Enumeration Date | 2022-06-14 |
| Last Update Date | 2025-03-19 |