Organization
KMART
Active
Organization
KMART
Active
Other names
Kmart Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KELECHI A AGUWA PHARMD (PHARMACY MANAGER)
(240) 994-3121
Entity
Organization
Contact information
Practice address
613 FIRST NATIONAL ST, IRONWOOD, MI 49938-3329
(240) 994-3121
Mailing address
613 FIRST NATIONAL ST, IRONWOOD, MI 49938-3329
(240) 994-3121
Taxonomy
Speciality
Code
Description
License number
State
305S00000X
Point of Service
Primary
530241688
MI
Other
Enumeration date
10/16/2013
Last updated
10/16/2013
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