<Unavail>

LBN: Great Lakes Medical Pharmacy Llc
<Unavail> is an health care organization with primary practice located at 23247 Pinewood St Ste 100, Warren MI 48091-4754. The organization recently has 2 registered licenses in different health care specialties including Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty. Great Lakes Medical Pharmacy Llc can be contacted via phone (954) 381-7146, or through Lazeki, Rami via phone (305) 455-3836.

Contact Information

Primary practice address
23247 Pinewood St Ste 100 Warren MI 48091-4754
Phone: (954) 381-7146
Fax: (877) 448-0633
Website:
Map and Directions
Authorized official contact:
Name: Lazeki, Rami
Phone: (305) 455-3836

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Pharmacy 333600000X
Suppliers / Community/Retail Pharmacy 3336C0003X 5301010234 Michigan

Profile Details

NPI number 1164692356
LBN Legal business name Great Lakes Medical Pharmacy Llc
DBA Doing business as <Unavail>
Authorized official Lazeki, Rami
Entity Organization
Organization subpart 1 No
Enumeration date Mar 4th, 2008
Last updated Jul 5th, 2016 - about 10 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1164692356 NPPES
Other 2144902 PK
MEDICAID 1164692356 PK

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