NPI | 1205544913 |
---|---|
Doing Business As | LIFE CHANGE PHARMACY 1 LONG TERM CARE |
Entity Type | Organization |
Authorized Contact | ALI AHMED NAFEA ALI Co Owner 414-999-0999 |
Organization Subpart ? | No |
Primary Taxonomy | 3336L0003X Pharmacy, Long Term Care Pharmacy |
Enumeration Date | 2022-11-10 |
Last Update Date | 2022-11-10 |