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
174H00000X
Health Educator
Primary
—
—
261QH0100X
Health Service Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0P57520
MASS IMMUNIZATION
MI
01
—
0P60030
PTAN
MI
05
—
1295918274
—
MI
01
—
1740306778
RPH NPI
MI
01
—
200810
DSME/ DPP
—
Enumeration date
01/23/2019
Last updated
06/01/2022
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