Organization
LIVERNOIS EXPRESS PHARMACY
Active
Other names
LIVERNOIS EXPRESS PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
C OLIVER DURU RPH (PHARMACIST/OWNER)
(313) 659-1622
Entity
Organization
Contact information
Practice address
15530 PURITAN ST, DETROIT, MI 48227-2342
(313) 659-1622
(313) 659-1621
Mailing address
15530 PURITAN ST, DETROIT, MI 48227-2342
(313) 659-1622
(313) 659-1621
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
5301008192
MI
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2041990
PK
—
05
—
2367553
—
MI
Enumeration date
07/30/2006
Last updated
01/20/2016
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