| NPI | 1952965576 |
|---|---|
| Doing Business As | LIFE CHANGE PHARMACY 2 |
| Entity Type | Organization |
| Authorized Contact | ALI A ALI C Owner 414-600-2000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Enumeration Date | 2019-04-29 |
| Last Update Date | 2021-01-15 |