# PRESTIGE SPECIALTY PHARMACY LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1548750714
- **Authorized official:** AMRO SHARAFELDIN (CEO)
- **Authorized official phone:** (877) 742-7621

## Contact information

- **Practice address:** 3739 15 MILE RD, STERLING HEIGHTS, MI 48310
- **Practice address phone:** (877) 742-7621
- **Practice address fax:** (586) 883-9388
- **Mailing address:** 3739 15 MILE RD, STERLING HEIGHTS, MI 48310
- **Mailing address phone:** (877) 742-7621
- **Mailing address fax:** (586) 883-9388

## Taxonomy

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

## Other

- **Enumeration date:** 05/14/2018
- **Last updated:** 06/05/2018

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1306340955 | — | MI |
| 01 | — | 2177646 | PK | — |