Organization
LOR VEN PHARMACY LLC
Active
Organization
LOR VEN PHARMACY LLC
Active
Other names
LOR VEN PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
MADAN AHEER (PHARMACIST)
(313) 737-4946
Entity
Organization
Contact information
Practice address
116 W 8 MILE RD, HAZEL PARK, MI 48030-2433
(248) 541-7606
Mailing address
116 W 8 MILE RD, HAZEL PARK, MI 48030-2433
(248) 629-9847
(248) 850-8369
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
5301009471
MI
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2374849
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
01/06/2011
Last updated
07/23/2012
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