| NPI | 1982888947 |
|---|---|
| Doing Business As | GREAT LAKES RX PHARMACY |
| Entity Type | Organization |
| Authorized Contact | WAEL KHANAFER Owner 133-412-4622 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: MI 5301008773) |
| Enumeration Date | 2007-12-26 |
| Last Update Date | 2009-05-08 |