Organization
SLBTJ PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS CHARLENE WILLIAMS (OWNER/CORP PRESIDENT)
(313) 881-3188
Entity
Organization
Contact information
Practice address
16101 MACK AVE, DETROIT, MI 48035
(313) 881-3188
(313) 881-3128
Mailing address
16101 MACK AVE, DETROIT, MI 48035
(313) 881-3188
(313) 881-3128
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
5301008445
MI
Other
Enumeration date
08/14/2007
Last updated
08/14/2007
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