# ADVANCED SPECIALTY RX LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Advanced Specialty Rx
- **Organization subpart:** No

## Provider details

- **NPI number:** 1295987253
- **Authorized official:** BASSAM YOUSSEF (OWNER)
- **Authorized official phone:** (810) 230-8300

## Contact information

- **Practice address:** 4488 W BRISTOL RD STE 350, FLINT, MI 48507-3111
- **Practice address phone:** (810) 232-2700
- **Practice address fax:** (888) 246-0436
- **Mailing address:** 4488 W BRISTOL RD STE 350, FLINT, MI 48507-3111
- **Mailing address phone:** (810) 232-2700
- **Mailing address fax:** (888) 246-0436

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0004X | Compounding Pharmacy | — | NULL | — |
| 3336L0003X | Long Term Care Pharmacy | 5301008902 | MI | Yes |
| 3336M0003X | Managed Care Organization Pharmacy | — | NULL | — |
| 3336S0011X | Specialty Pharmacy | — | NULL | — |

## Other

- **Enumeration date:** 10/21/2008
- **Last updated:** 10/12/2021

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 2125139 | PK | — |