| NPI | 1871992271 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTINA FERGUSON Administrative Assistant 989-705-1395 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: MI 380-85-8390) |
| Enumeration Date | 2014-08-21 |
| Last Update Date | 2014-08-21 |