| NPI | 1750140661 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISHNA KANDAGATLA Owner 517-574-5015 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336L0003X Pharmacy, Long Term Care Pharmacy |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2024-03-14 |
| Last Update Date | 2024-03-21 |