Organization
ISIDRO II INC
Active
Parent organization
ISIDRO II INC
Other names
University Pharmacy
Organization subpart
Yes
Provider details
NPI number
Legal business name
ISIDRO II INC
Authorized official
MARIA CHRISTINA YOUNG (PRESIDENT)
(734) 812-9129
Entity
Organization
Contact information
Practice address
7288 N SHELDON RD STE A, CANTON, MI 48187-2150
(734) 812-9129
(734) 629-1717
Mailing address
PO BOX 871819, CANTON, MI 48187-7519
(734) 812-9129
(734) 629-1717
Taxonomy
Speciality
Code
Description
License number
State
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
—
—
261QH0100X
Health Service Clinic/Center
—
—
333600000X
Pharmacy
—
—
3336C0002X
Clinic Pharmacy
Primary
—
—
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0P57520
PHARMACY
MI
01
—
0P60030
MASS IMMUNIZATION
MI
05
—
1295918274
—
MI
01
—
1477673325
RPH PHARM D PROVIDER
—
01
—
1740306778
RPH PROVIDER
MI
Enumeration date
05/21/2019
Last updated
06/01/2022
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