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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