Organization
LONG LAKE RX PHARMACY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TANVEER HUSSAIN (PRESIDENT)
(586) 822-0336
Entity
Organization
Contact information
Practice address
2888 E LONG LAKE RD, TROY, MI 48085-3793
(586) 822-0336
(425) 486-6367
Mailing address
2888 E LONG LAKE RD, TROY, MI 48085-3793
(586) 822-0336
(425) 486-6367
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
5301011359
MI
Other
Enumeration date
04/12/2018
Last updated
04/12/2018
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