NPI: 1013394378 · TROY, MI 48084 · Pharmacy · NPI assigned 05/06/2015
| Authorized Official | BOUTROS, PIERRE (PHARMACY DIRECTOR) |
| NPI Enumeration Date | 05/06/2015 |
| Year | Claims | Total Paid |
|---|---|---|
| 2021 | 14 | $302.80 |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 0011A | 14 | 14 | $302.80 |