Organization
ISIDRO II INC
Active
Other names
UNIVERSITY PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
MARIA YOUNG RPH (OWNER, PRES, PIC)
(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
332900000X
Non-Pharmacy Dispensing Site
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0002X
Clinic Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
5301008406
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0P57520
PTAN
MI
01
—
0P60030
MASS IMMUNIZATION
MI
05
—
1295918274
—
MI
05
—
1982884318
—
MI
01
—
2043557
PK
—
Enumeration date
12/12/2007
Last updated
04/30/2025
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