NPI | 1760193395 |
---|---|
Doing Business As | GREAT LAKES BAY HEALTH CENTERS PHARMACY OLD TOWN |
Entity Type | Organization |
Authorized Contact | DAWN CHRISTIAN Provider Enrollment 989-759-6464 |
Organization Subpart ? | No |
Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
Enumeration Date | 2022-12-05 |
Last Update Date | 2022-12-05 |