| NPI | 1962801373 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NISAR AHMED Pharmacist In Charge 313-535-9755 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305S00000X Point of Service (Licence: MI 5315049752) |
| Enumeration Date | 2014-08-21 |
| Last Update Date | 2014-08-21 |