Organization
LIVERNOIS FAMILY PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHEHRBANO HUSSAIN (PHARMACIST ENCHARGE)
(313) 341-3511
Entity
Organization
Contact information
Practice address
18254 LIVERNOIS AVE, DETROIT, MI 48221-4214
(313) 341-3511
(313) 341-3624
Mailing address
182554 LIVERNOIS AVE, DETROIT, MI 48221
(313) 341-3511
(313) 341-3624
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
5301007422
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2362957
NABP NUMBER
MI
05
—
4192614
—
MI
01
—
4770683
MICHIGAN MEDICAID DME
MI
Enumeration date
10/18/2006
Last updated
02/21/2008
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