Organization
LIVERNOIS PHARMACY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELGHOUL MOSTAPHA (PHARMACIST)
(313) 361-6100
Entity
Organization
Contact information
Practice address
6240 MICHIGAN AVE, DETROIT, MI 48210-2953
(313) 361-6100
(313) 361-6116
Mailing address
6240 MICHIGAN AVE, DETROIT, MI 48210-2953
(313) 361-6100
(313) 361-6116
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
5315020661
MI
Other
Enumeration date
02/15/2007
Last updated
08/22/2020
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