Organization
EL NOOR LLC
Active
Other names
Premierx Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MARIAM ALBOUSTANI (OWNER/ PHARMACIST)
(248) 957-9100
Entity
Organization
Contact information
Practice address
20292 MIDDLEBELT RD, SUITE B, LIVONIA, MI 48152-2002
(248) 957-9100
(248) 957-9111
Mailing address
20292 MIDDLEBELT RD, SUITE B, LIVONIA, MI 48152-2002
(248) 957-9100
(248) 957-9111
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
5301010284
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1518392281
—
MI
01
—
2142165
PK
—
Enumeration date
09/12/2013
Last updated
02/24/2014
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