PHARMASOURCE LTC LLC NPI 1043789431

NPI Information

  • NPI: 1043789431
  • Provider Name: PHARMASOURCE LTC LLC
  • Classification: Pharmacy - 3336L0003X
  • Specialization: Long Term Care Pharmacy
  • Entity Type: Organization
  • CLIA Number: 23D2188870
  • Address: 31620 GRAND RIVER AVE
    FARMINGTON, MI
    ZIP 48336
  • Phone: (313) 680-3000

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NPI Details

PHARMASOURCE LTC LLC is a long term care pharmacy pharmacy in Farmington, 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. PHARMASOURCE LTC LLC NPI is 1043789431. The provider is registered as an organization entity type.

The provider's business location address is:

31620 GRAND RIVER AVE
FARMINGTON, MI
ZIP 48336-234
Phone: (313) 680-3000

The provider's authorized official is Fadi Naserdean .
The authorized official title is Principal and has the following contact phone number (734) 261-4100.

The CLIA number assigned to this NPI record is 23D2188870 - pharmacy with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/15/2018 and was last updated on 1/22/2020.

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
13336L0003XPharmacyLong Term Care PharmacyYes

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: 11/21/2025

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