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General NPI Number Information
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NPI Number | 1316405848
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Entity Type | Organization
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Legal Business Name | LIFETIME RX PHARMACY
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Dates
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Enumeration Date | 03/04/2019
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Last Update Date | 12/13/2023
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Provider Practice Location Address
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Address Line | 1022 N TELEGRAPH RD SUITE 1
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City | DEARBORN
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State | MI
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Zip | 48128
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Country | US
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Telephone | 313-908-9722
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Fax | 313-908-9769
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Provider Business Mailing Address
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Address Line | 1022 N TELEGRAPH SUITE 1
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City | DEARBORN
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State | MI
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Zip | 48128
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Country | US
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Telephone | 313-970-2458
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. HASAN ALI SABBAGH
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Credential |
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Telephone | 313-348-0561
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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 |
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License Number State |
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