# LONG LIFE PHARMACY LLC

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

## Provider details

- **NPI number:** 1699334532
- **Authorized official:** DR. MOATH M SARSOUR PH-D (OWNER)
- **Authorized official phone:** (414) 375-6112

## Contact information

- **Practice address:** 1672 S 9TH ST UNIT D, MILWAUKEE, WI 53204-3426
- **Practice address phone:** (414) 326-0888
- **Mailing address:** 1255 E HICKORY CREEK CT, OAK CREEK, WI 53154-7316
- **Mailing address phone:** (414) 375-6112
- **Mailing address fax:** (414) 375-6113

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0003X | Community/Retail Pharmacy | — | NULL | Yes |

## Other

- **Enumeration date:** 06/12/2019
- **Last updated:** 06/23/2026