Organization
LIFETIME PHARMACY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HASSAN FAKIH PHARMD (OWNER/PIC)
(574) 318-4195
Entity
Organization
Contact information
Practice address
212 W EDISON RD STE A, MISHAWAKA, IN 46545-8301
(574) 318-4195
(574) 318-4936
Mailing address
19120 OAKMONT SOUTH DR, SOUTH BEND, IN 46637-3529
(313) 828-2794
Taxonomy
Speciality
Code
Description
License number
State
3336C0004X
Compounding Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
Primary
—
—
Other
Enumeration date
03/07/2025
Last updated
03/07/2025
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