| NPI | 1831100478 |
|---|---|
| Doing Business As | BELAVISTA PHARMACY INC |
| Entity Type | Organization |
| Authorized Contact | ALI NASSAR President 313-485-1411 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: MI 5301007885) |
| Additional Taxonomies | 3336C0004X Pharmacy, Compounding Pharmacy |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| 333600000X Pharmacy | |
| Enumeration Date | 2006-08-10 |
| Last Update Date | 2012-08-10 |