| NPI | 1871813238 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOROTHY SAMSON Pharmacy Manager (PIC) 313-283-9025 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: TX 26934) |
| Additional Taxonomies | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Enumeration Date | 2010-06-09 |
| Last Update Date | 2018-01-07 |