# PALMER LTC PHARMACY LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** PALMER LTC PHARMACY LLC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1194296707
- **Authorized official:** CHAWKI M FAKIH (PHARMACIST IS CHARGE)
- **Authorized official phone:** (313) 438-1078

## Contact information

- **Practice address:** 4020 VENOY RD STE 900B, WAYNE, MI 48184-4818
- **Practice address phone:** (313) 438-5157
- **Mailing address:** 4020 VENOY RD STE 900B, WAYNE, MI 48184-1869
- **Mailing address phone:** (313) 438-5157
- **Mailing address fax:** (616) 825-6237

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336L0003X | Long Term Care Pharmacy | — | NULL | Yes |

## Other

- **Enumeration date:** 12/07/2018
- **Last updated:** 12/07/2018