Organization
LEVAN MEDICAL PHARMACY LLC
Active
Other names
Levan Medical Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MUSTAPHA HUSSEIN RPH (MEMBER)
(734) 462-8005
Entity
Organization
Contact information
Practice address
15132 LEVAN RD, STE 32, LIVONIA, MI 48154-5027
(734) 462-8005
(734) 462-8009
Mailing address
15132 LEVAN RD, STE 32, LIVONIA, MI 48154-5027
(734) 462-8005
(734) 462-8009
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
5301009050
MI
3336C0004X
Compounding Pharmacy
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2372376
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
01/26/2009
Last updated
04/23/2010
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