Organization
LAKELAND PHARMACY PC
Active
Other names
Lakeland Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
ALI FAKIH (PRESIDENT)
(810) 231-2020
Entity
Organization
Contact information
Practice address
5589 E M36, STE A10, PINCKNEY, MI 48169-9260
(810) 231-2020
(810) 231-2258
Mailing address
PO BOX 5185, DEARBORN, MI 48128-0185
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
5301009067
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2372441
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
01/27/2009
Last updated
05/28/2009
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