Organization
LAFAYETTE PHARMACY LLC
Active
Other names
PharMor Pharmacy- Lafayette
Organization subpart
No
Provider details
NPI number
Authorized official
MOHAMED SOHOUBAH (OWNER)
(313) 396-5555
Entity
Organization
Contact information
Practice address
1565 E LAFAYETTE ST, DETROIT, MI 48207-2958
(313) 396-5555
(313) 396-5665
Mailing address
23815 NORTHWESTERN HWY, SUITE 215, SOUTHFIELD, MI 48075-7738
(248) 663-3380
(248) 419-2976
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
5301009705
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2132926
PK
—
Enumeration date
12/15/2011
Last updated
03/13/2015
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