Provider Demographics
NPI:1275925950
Name:HEALTH PRO LLC
Entity Type:Organization
Organization Name:HEALTH PRO LLC
Other - Org Name:LIVESTRONG PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MASHIYAT
Authorized Official - Middle Name:
Authorized Official - Last Name:RASHID
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-943-1216
Mailing Address - Street 1:3011 W GRAND BLVD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48202-3096
Mailing Address - Country:US
Mailing Address - Phone:313-733-1216
Mailing Address - Fax:313-888-9124
Practice Address - Street 1:3011 W GRAND BLVD
Practice Address - Street 2:SUITE 300
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48202-3096
Practice Address - Country:US
Practice Address - Phone:313-733-1216
Practice Address - Fax:313-888-9124
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-04
Last Update Date:2017-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI53010110693336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy