Registry details
Type
Individual
Primary specialty
Pharmacist
Enumerated
Jan 30, 2020
License(s)
5302027050 (MI)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | 21777 21 MILE RD | Macomb, MI 48044-2962 | 586-949-2082 |
| LOCATION | 21777 21 MILE RD | Macomb, MI 48044-2962 | 586-949-2082 |
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.