Organization
DORT LONGWAY PHARMACY LLC
Active
Other names
Dort Longway Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
AHMED ZAKI (CEO/PRESIDENT)
(810) 813-0040
Entity
Organization
Contact information
Practice address
2700 ROBERT T LONGWAY BLVD, STE B, FLINT, MI 48503-2190
(810) 235-2800
(810) 235-2803
Mailing address
2700 ROBERT T LONGWAY BLVD, STE B, FLINT, MI 48503-2190
(810) 235-2800
(810) 235-2803
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
5301009732
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2376259
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
01/02/2012
Last updated
08/21/2012
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