Organization
INTEGRATED DRUG MANAGEMENT
Active
Other names
IDM PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
FAUSTINA IROHA (CEO)
(248) 943-1123
Entity
Organization
Contact information
Practice address
26541 PLYMOUTH RD, REDFORD, MI 48239-2214
(313) 543-3414
(313) 543-3416
Mailing address
26541 PLYMOUTH RD, REDFORD, MI 48239-2214
(313) 543-3414
(313) 543-3414
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
5315052908
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1316220155
—
MI
01
—
2132642
PK
—
Enumeration date
09/27/2011
Last updated
12/13/2016
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