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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