| NPI | 1750474680 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHILIP GERARD THOM Director Of Operations 810-733-0280 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336H0001X Pharmacy, Home Infusion Therapy Pharmacy |
| Additional Taxonomies | 3336L0003X Pharmacy, Long Term Care Pharmacy |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2018-03-06 |