| NPI | 1811232614 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN HURN Director, Pharmacy Administration 616-791-5185 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: 60006321A) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: 60006321A) |
| Enumeration Date | 2012-12-05 |
| Last Update Date | 2012-12-05 |