| NPI | 1962585950 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EMILY LYNN RAHEMI Office Manager 269-501-7034 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy |
| Additional Taxonomies | 3336I0012X Pharmacy Institutional Pharmacy |
| 3336L0003X Pharmacy Long Term Care Pharmacy | |
| Enumeration Date | 2006-10-23 |
| Last Update Date | 2023-03-07 |