NPI: 1962051102 · OAK PARK, MI 48237 · Community/Retail Pharmacy · NPI assigned 09/10/2019
| Authorized Official | PONOMAREV, PETER (RPH) |
| NPI Enumeration Date | 09/10/2019 |
| Year | Claims | Total Paid |
|---|---|---|
| 2020 | 160 | $293.56 |
| 2021 | 566 | $2K |
| 2022 | 496 | $2K |
| 2023 | 249 | $1K |
| 2024 | 269 | $1K |