Organization
CHILDRENS HOSPITAL OF MICHIGAN
Active
Organization
CHILDRENS HOSPITAL OF MICHIGAN
Active
Other names
DMC PHARMACY STILSON CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL YOUNG (EXECUTIVE DIR)
(313) 966-0392
Entity
Organization
Contact information
Practice address
42700 GARFIELD RD, CLINTON TOWNSHIP, MI 48038-4201
(586) 532-2980
(586) 416-1432
Mailing address
PO BOX 674032, DETROIT, MI 48267-4032
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
5301008761
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2370649
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
01/10/2008
Last updated
04/10/2009
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