Organization
DETR MED CTR HARPER HOSP
Active
Organization
DETR MED CTR HARPER HOSP
Active
Other names
DMC PAHRMACY HUTZEL
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL YOUNG (SYS EXEC DIR RETL PHRM)
(313) 966-0392
Entity
Organization
Contact information
Practice address
4727 SAINT ANTOINE ST, STE 100A, DETROIT, MI 48201-1461
(313) 745-7444
(313) 745-7443
Mailing address
PO BOX 673896, DETROIT, MI 48267-3896
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
5301008580
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2369533
NCPDP PROVIDER IDENTIFICATION NUMBER
—
05
—
2369533
—
MI
Enumeration date
04/03/2007
Last updated
02/17/2009
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