MEDICARE: LIFETIME PHARMACY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	333600000X	Pharmacy
2	3336C0003X	Community/Retail Pharmacy
3	3336M0002X	Mail Order Pharmacy

General Provider Information

NPI Number	:	1881563393
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LIFETIME PHARMACY

Provider Business Mailing Address
First Line	:	2142 MONROE ST
Second Line	:
City	:	DEARBORN
State	:	MI
Zip	:	48124-3057
Country	:	US
Telephone Number	:	313-444-2482
Fax Number	:

Provider Business Practice Location Address
First Line	:	2142 MONROE ST
Second Line	:
City	:	DEARBORN
State	:	MI
Zip	:	48124-3057
Country	:	US
Telephone Number	:	313-444-2482
Fax Number	:

Authorized Official
Title or Position	:	PIC
Name	:	ALIEDDIN ALAIWAT
Credential	:	PHARM.D.
Telephone Number	:	313-675-6301

Provider Enumeration Date	:	11/03/2025
Last Update Date	:	11/03/2025

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Directions to “LIFETIME PHARMACY ” Practice Location

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