Organization
LIVE WELL RX LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KASSEM KLEIT PHARMD (OWNER)
(734) 927-2878
Entity
Organization
Contact information
Practice address
3270 GREENFIELD RD STE 101, BERKLEY, MI 48072-1161
(248) 284-6969
(248) 284-6963
Mailing address
7651 SCHAEFER RD, DEARBORN, MI 48126-1143
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
5301011415
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5301011415
MICHIGAN PHARMACY LICENSE
MI
01
—
5315094600
MICHIGAN PHARMACY CS LICENSE
MI
Enumeration date
07/16/2018
Last updated
04/17/2019
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