NPI 1124456884

Kmart

Organisation Point of Service Ironwood, MI

Practice location

Address: 613 First National St, Ironwood, MI 49938-3329
Phone: (240) 994-3121

Authorised official

Name: Kelechi a Aguwa
Title: Pharmacy Manager
Phone: (240) 994-3121

Registered specialties

Point of Service Primary

Managed Care Organizations Taxonomy 305S00000X Licence 530241688 (MI)

Other Point of Service providers in Michigan →

Registry record

NPI: 1124456884
Entity type: Organization
NPI issued: 16 Oct 2013
Record last updated: 16 Oct 2013

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.