NPI | 1932648896 |
---|---|
Doing Business As | GREAT LAKES PHARMACY LLC |
Entity Type | Organization |
Authorized Contact | ANIRUDDHA PATHAK Mgr,PIC, AO 443-783-5539 |
Organization Subpart ? | No |
Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: MI 5301011109) |
Additional Taxonomies | 333600000X Pharmacy |
Enumeration Date | 2017-02-13 |
Last Update Date | 2017-04-20 |