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General NPI Number Information
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NPI Number | 1417738691
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Entity Type | Organization
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Legal Business Name | LIFETIME RX OF DEARBORN HEIGHTS
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Dates
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Enumeration Date | 10/12/2023
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Last Update Date | 12/13/2023
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Provider Practice Location Address
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Address Line | 4245 BEECH S BEECH DALY SUITE 101
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City | DEARBRON HEIGHTS
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State | MI
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Zip | 48125
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Country | US
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Telephone | 313-768-5037
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Fax | 313-768-5039
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Provider Business Mailing Address
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Address Line | 4245 BEECH S BEECH DALY SUITE 101
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City | DEARBRON HEIGHTS
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State | MI
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Zip | 48125
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | HASAN SABBAGH
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Credential |
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Telephone | 313-970-2458
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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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