| NPI | 1891970265 |
|---|---|
| Doing Business As | LTC MED EX DIRECT |
| Entity Type | Organization |
| Authorized Contact | JOHN M GALLANT President 586-353-6337 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336L0003X Pharmacy, Long Term Care Pharmacy (Licence: MI 5315034144) |
| Additional Taxonomies | 3336C0004X Pharmacy, Compounding Pharmacy (Licence: MI 5315034144) |
| Enumeration Date | 2008-01-04 |
| Last Update Date | 2015-06-11 |