Healthcare Provider Details

I. General information

NPI: 1316881451
Provider Name (Legal Business Name): VIVACARE PHARMACY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/17/2026
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1214 N PERRY ST
PONTIAC MI
48340
US

IV. Provider business mailing address

1214 N PERRY ST
PONTIAC MI
48340
US

V. Phone/Fax

Practice location:
  • Phone: 947-886-2346
  • Fax: 947-886-2347
Mailing address:
  • Phone: 947-886-2346
  • Fax: 947-886-2347

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: HUSSEIN EL-SIBAI
Title or Position: OWNER
Credential:
Phone: 313-422-3532