| NPI | 1891798401 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERIC M GRAHAM President 269-488-2630 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: MI 5301008128) |
| Additional Taxonomies | 3336L0003X Pharmacy Long Term Care Pharmacy (Licence: MI 5301008128) |
| 3336S0011X Pharmacy Specialty Pharmacy (Licence: MI 5301008128) | |
| 332B00000X Durable Medical Equipment & Medical Supplies (Licence: MI 5447160001) | |
| Enumeration Date | 2005-05-27 |
| Last Update Date | 2008-04-20 |