| NPI | 1750347340 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FREDERICK GHANNAM Owner 810-232-9270 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy |
| Additional Taxonomies | 333600000X Pharmacy (Licence: MI 5301007108) |
| Enumeration Date | 2006-04-24 |
| Last Update Date | 2023-03-07 |