Organization
ISIDRO II, INC
Active
Other names
University Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MARIA CHRISTINA YOUNG BS PHARM (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
333600000X
Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
23D1083577
CLIA
—
01
—
5301012844
PHARMACY LICENSE
MI
Enumeration date
06/08/2022
Last updated
06/08/2022
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