Registry details
Type
Individual
Primary specialty
Pharmacist
Enumerated
Jun 22, 2020
License(s)
5315110358 (MI)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| LOCATION | 4646 JOHN R ST | Detroit, MI 48201-1916 | 313-576-1000 |
| MAILING | 4646 JOHN R ST | Detroit, MI 48201-1916 |
Watch this provider
Get a webhook/email the day this provider is added to the OIG-LEIE exclusion list or appears in an FDA enforcement action.