| NPI | 1942580972 |
|---|---|
| Doing Business As | GREAT LAKES PHARMACY OF MIDLAND |
| Entity Type | Organization |
| Authorized Contact | DAVID ALLEN Owner 989-615-7212 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: MI 5301009642) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| 333600000X Pharmacy | |
| Enumeration Date | 2011-08-22 |
| Last Update Date | 2019-04-26 |