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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