Organization
ADAM LIVONIA INC
Active
Other names
LifeCare Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
WANSA MAKKI (OWNER)
(313) 231-2262
Entity
Organization
Contact information
Practice address
8810 MIDDLEBELT RD, LIVONIA, MI 48150-4052
(734) 261-4400
(734) 261-4803
Mailing address
8810 MIDDLEBELT RD, LIVONIA, MI 48150-4052
(734) 261-4400
(734) 261-4803
Taxonomy
Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary
5301008402
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2368480
NCPDP PROVIDER IDENTIFICATION NUMBER
—
05
—
4936548
—
MI
Enumeration date
08/18/2006
Last updated
05/17/2012
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