Healthcare Provider Details

I. General information

NPI: 1053287599
Provider Name (Legal Business Name): RIVERVIEW HEALTH PHARMACY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/13/2025
Last Update Date: 10/13/2025
Certification Date: 10/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19020 FORT ST STE PHARMACY
RIVERVIEW MI
48193-6701
US

IV. Provider business mailing address

19020 FORT ST STE PHARMACY
RIVERVIEW MI
48193-6701
US

V. Phone/Fax

Practice location:
  • Phone: 734-992-7949
  • Fax:
Mailing address:
  • Phone:
  • Fax:

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: NISRINE AWADA
Title or Position: OWNER
Credential:
Phone: 734-992-7949