| NPI | 1770974750 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOAA KOTB Owner 810-394-5416 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy |
| Additional Taxonomies | 333600000X Pharmacy (Licence: FL PH28356) |
| 333600000X Pharmacy | |
| Enumeration Date | 2015-02-11 |
| Last Update Date | 2025-08-28 |