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General NPI Number Information
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NPI Number | 1831780683
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Entity Type | Organization
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Legal Business Name | LIVONIA EXPRESS PHARMACY LLC
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Dates
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Enumeration Date | 02/02/2021
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Last Update Date | 12/02/2021
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Provider Practice Location Address
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Address Line | 28275 FIVE MILE RD
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City | LIVONIA
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State | MI
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Zip | 48154-3998
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Country | US
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Telephone | 313-674-5968
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Fax | 313-406-6783
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Provider Business Mailing Address
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Address Line | 28275 FIVE MILE RD
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City | LIVONIA
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State | MI
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Zip | 48154-3998
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Country | US
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Telephone | 734-237-4949
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Fax | 313-406-6783
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Authorized Official
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Title or Position | OWNER
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Name | SAHER ABDULMALEK
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Credential |
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Telephone | 313-674-5968
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336S0011X
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Taxonomy Name | Specialty 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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