Organization
LIVE WELL PHARMACY INC
Active
Other names
Live Well Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
NOORA MERAM B.SC. PHARMACY (PRESIDENT)
(248) 381-4000
Entity
Organization
Contact information
Practice address
23411 JOHN R RD, HAZEL PARK, MI 48030-1404
(248) 381-4000
(248) 381-4046
Mailing address
23411 JOHN R RD, HAZEL PARK, MI 48030-1404
(248) 381-4000
(248) 381-4046
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
5301010026
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1043569338
—
MI
01
—
2138523
PK
—
Enumeration date
09/03/2012
Last updated
03/01/2017
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