Provider Demographics
NPI:1942560529
Name:LIVONIA CARE PHARMACY INC
Entity Type:Organization
Organization Name:LIVONIA CARE PHARMACY INC
Other - Org Name:LIVONIA CARE PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACY OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NILESHKUMAR
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:734-437-1956
Mailing Address - Street 1:16989 FARMINGTON RD
Mailing Address - Street 2:
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48154-2946
Mailing Address - Country:US
Mailing Address - Phone:734-437-1956
Mailing Address - Fax:734-437-6360
Practice Address - Street 1:16989 FARMINGTON RD
Practice Address - Street 2:
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48154-2946
Practice Address - Country:US
Practice Address - Phone:734-437-1956
Practice Address - Fax:734-437-6360
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-17
Last Update Date:2012-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
MI53010098023336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2376805OtherNCPDP PROVIDER IDENTIFICATION NUMBER