Provider Demographics
NPI:1295379667
Name:NOVI PHARMACY LLC
Entity Type:Organization
Organization Name:NOVI PHARMACY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:OSAMAH
Authorized Official - Middle Name:
Authorized Official - Last Name:ALKOSHAB
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-536-2020
Mailing Address - Street 1:39575 W 10 MILE RD STE 203
Mailing Address - Street 2:
Mailing Address - City:NOVI
Mailing Address - State:MI
Mailing Address - Zip Code:48375-2949
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:39575 W 10 MILE RD STE 203
Practice Address - Street 2:
Practice Address - City:NOVI
Practice Address - State:MI
Practice Address - Zip Code:48375-2949
Practice Address - Country:US
Practice Address - Phone:248-536-2020
Practice Address - Fax:248-536-2063
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-29
Last Update Date:2020-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy