Provider Type Icon

LAKEWOOD FAMILY PHARMACY LLC NPI 1326588294


NPI Information

NPI: 1326588294
Provider Name: LAKEWOOD FAMILY PHARMACY LLC

Doing Business As: DEARBORN FAMILY PHARMACY LTC

Classification: Pharmacy - 3336L0003X
Entity Type: Organization

Specialization: Long Term Care Pharmacy

CLIA Number: 23D2192710

Address:
17000 EXECUTIVE PLAZA DR STE 209
DEARBORN, MI
ZIP 48126
Phone: (313) 982-3770
Get Directions

LAKEWOOD FAMILY PHARMACY LLC is a long term care pharmacy pharmacy in Dearborn, MI. The provider is a pharmacy that dispenses medicinal preparations delivered to patients residing within an intermediate or skilled nursing facility, including intermediate care facilities, hospice, assisted living facilities, group homes, and other forms of congregate living arrangements. LAKEWOOD FAMILY PHARMACY LLC NPI is 1326588294. The provider is registered as an organization entity type.
The provider Is Doing Business As Dearborn Family Pharmacy Ltc.

The provider's business location address is:

17000 EXECUTIVE PLAZA DR STE 209
DEARBORN, MI
ZIP 48126-793
Phone: (313) 982-3770
Fax: (313) 982-3771

The provider's authorized official is Hassan Ismail .
The authorized official title is Owner and has the following contact phone number (313) 982-3770.

The CLIA number assigned to this NPI record is 23D2192710 - pharmacy with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/27/2017 and was last updated on 1/23/2024.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
13336C0003XPharmacyCommunity/Retail Pharmacy5301011107MICHIGANNo
23336S0011XPharmacySpecialty PharmacyNo
3333600000XPharmacyNo
43336L0003XPharmacyLong Term Care PharmacyYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
12383052MEDICAIDMICHIGAN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.