# SAM'S PHARMACY PLLC LONG TERM CARE

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** SAM'S PHARMACY PLLC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1891661096
- **Legal business name:** SAM'S PHARMACY PLLC
- **Authorized official:** BASSAM HARATI (PIC PHARMD)
- **Authorized official phone:** (313) 340-7777

## Contact information

- **Practice address:** 14533 LIVERNOIS AVE, DETROIT, MI 48238-2010
- **Practice address phone:** (313) 525-0110
- **Practice address fax:** (313) 340-4449
- **Mailing address:** 14533 LIVERNOIS AVE, DETROIT, MI 48238-2010
- **Mailing address phone:** (313) 340-7777
- **Mailing address fax:** (313) 340-4449

## Taxonomy

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

## Other

- **Enumeration date:** 10/14/2025
- **Last updated:** 11/01/2025

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1558700138 | — | MI |