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| Type | Company | [sources] | |||
|---|---|---|---|---|---|
| Name | Super Mart Pharmacy | [sources] | |||
| Incorporation date | not available | [sources] | |||
| Jurisdiction | not available | [sources] | |||
| Country | United States | [sources] | |||
| Description | License number: 5301009405 | [sources] | |||
| NPI | 1124322128 | [sources] | |||
| Registration number | not available | [sources] | |||
| Sector | Pharmacy | [sources] | |||
| Address | Detroit, MI | [sources] | |||
| Last change | Last processed | First seen | |||
Providers who have been terminated for cause from Michigan's Medicaid program.
United States · MDHHS
us-medmi-bede2145f0935ae664f7d95f65bc3e409b94255c · us-npi-1124322128For experts: raw data explorer
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