Organization
XME INC
Active
Other names
MIDLAND SABOURIN'S PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER WYSOPAL RPH (RPH)
(989) 839-2403
Entity
Organization
Contact information
Practice address
314 W WACKERLY ST STE L, MIDLAND, MI 48640-2766
(989) 839-2402
(989) 839-2405
Mailing address
314 W WACKERLY ST STE L, MIDLAND, MI 48640-2766
(989) 839-2402
(989) 839-2405
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
5301007501
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1073563607
—
MI
01
—
2046023
PK
—
05
—
483336
—
MI
Enumeration date
05/12/2006
Last updated
06/29/2016
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