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General NPI Number Information
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NPI Number | 1790042612
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Entity Type | Organization
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Legal Business Name | GREATER GOOD INC
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Dates
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Enumeration Date | 04/17/2012
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Last Update Date | 05/12/2014
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Provider Practice Location Address
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Address Line | 16700 HARPER AVE
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City | DETROIT
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State | MI
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Zip | 48224-1909
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Country | US
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Telephone | 313-886-3536
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Fax | 313-886-3553
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Provider Business Mailing Address
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Address Line | 16700 HARPER AVE
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City | DETROIT
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State | MI
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Zip | 48224-1909
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Country | US
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Telephone | 313-886-3536
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Fax | 313-886-3553
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Authorized Official
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Title or Position | PHARMACIST IN CHARGE
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Name | JUDE OBIAKOR
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Credential |
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Telephone | 313-886-3536
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 5301009783
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License Number State | MI
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