Provider Demographics
NPI:1780228676
Name:ALAVAR SPECIALTY PHARMACY, LLC
Entity Type:Organization
Organization Name:ALAVAR SPECIALTY PHARMACY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:AVROHOM
Authorized Official - Middle Name:
Authorized Official - Last Name:KRAVETZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-569-8605
Mailing Address - Street 1:18877 W 10 MILE RD STE 107
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48075-2628
Mailing Address - Country:US
Mailing Address - Phone:248-509-8379
Mailing Address - Fax:248-457-5552
Practice Address - Street 1:18877 W 10 MILE RD STE 107
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48075-2628
Practice Address - Country:US
Practice Address - Phone:248-509-8379
Practice Address - Fax:248-457-5552
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-04
Last Update Date:2019-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy