Provider Demographics
NPI:1326420357
Name:LIVONIA FAMILY PHARMACY LLC
Entity Type:Organization
Organization Name:LIVONIA FAMILY PHARMACY LLC
Other - Org Name:LIVONIA FAMILY PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST IN CHARGE
Authorized Official - Prefix:
Authorized Official - First Name:RAND
Authorized Official - Middle Name:
Authorized Official - Last Name:SOFIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:734-744-7636
Mailing Address - Street 1:15983 MIDDLEBELT RD
Mailing Address - Street 2:
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48154-3311
Mailing Address - Country:US
Mailing Address - Phone:734-744-7636
Mailing Address - Fax:734-743-5327
Practice Address - Street 1:15983 MIDDLEBELT RD
Practice Address - Street 2:
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48154-3311
Practice Address - Country:US
Practice Address - Phone:734-744-7636
Practice Address - Fax:734-743-5327
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-25
Last Update Date:2020-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy