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Organization

LIFESMART PHARMACY LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ADHAM MALLAH (OWNER/PRESIDENT)
(313) 478-7823
Entity
Organization

Contact information

Practice address
2176 FORT ST, LINCOLN PARK, MI 48146-2405
(313) 768-5858
(313) 768-5868
Mailing address
2176 FORT ST, LINCOLN PARK, MI 48146-2405
(313) 768-5096
(313) 768-5098

Taxonomy

Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary

Other

Enumeration date
09/19/2018
Last updated
09/08/2023
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