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General NPI Number Information
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NPI Number | 1609233162
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Entity Type | Organization
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Legal Business Name | LANSING SPECIALTY PHARMACY LLC
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Dates
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Enumeration Date | 01/28/2016
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Last Update Date | 12/07/2020
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Provider Practice Location Address
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Address Line | 1174 FORT ST
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City | LINCOLN PARK
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State | MI
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Zip | 48146-1895
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Country | US
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Telephone | 586-774-7294
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Fax | 586-774-7298
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Provider Business Mailing Address
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Address Line | 1174 FORT ST
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City | LINCOLN PARK
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State | MI
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Zip | 48146-1895
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Country | US
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Telephone | 586-774-7294
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Fax | 586-774-7298
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Authorized Official
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Title or Position | OWNER
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Name | ALI H EL KHATIB
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Credential |
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Telephone | 313-414-0249
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | 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 | 5301010799
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License Number State | MI
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Taxonomy #3
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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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