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General NPI Number Information
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NPI Number | 1427402536
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Entity Type | Organization
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Legal Business Name | PLATINUM LIFE PHARMACY PLLC
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Dates
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Enumeration Date | 04/15/2016
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 30785 ANN ARBOR TRL
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City | WESTLAND
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State | MI
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Zip | 48185-2473
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Country | US
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Telephone | 734-469-2424
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Fax | 734-469-2428
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Provider Business Mailing Address
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Address Line | 30785 ANN ARBOR TRL
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City | WESTLAND
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State | MI
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Zip | 48185-2473
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Country | US
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Telephone | 734-469-2424
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MRS. REGINA AMADI
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Credential | PHARM D
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Telephone | 734-330-3262
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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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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