Organization
ADVANCED RX LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. FADI NASERDEAN PHARM.D, MD (PRESIDENT)
(313) 680-3000
Entity
Organization
Contact information
Practice address
838 4TH AVE, LAKE ODESSA, MI 48849-1054
(616) 374-3190
Mailing address
PO BOX 660, DEARBORN HEIGHTS, MI 48127-0660
(313) 680-3000
Taxonomy
Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary
PENDING
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
MI
Enumeration date
09/18/2017
Last updated
09/12/2025
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