La Vita LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

LA VITA LLC

Doing business as

Hamzeh Pharmacy

Practice address

10437 W Warren Ave
Dearborn, MI 48126

Phone

(313) 582-1670

Fax

(313) 582-0707

NPI assigned

Aug 14, 2017

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Azzam MoussawelNPI 1265749840

Title

Pharm.D.

Phone

(734) 718-3705

Specialties & licenses 1

Addresses

Other names 1

• Hamzeh Pharmacy Doing business as

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Azzam F Moussawel, PHARM.D.

  • Pharmacist
  • Madison Heights, MI
  • NPI 1265749840
  NPD Authorized official
• Nancy Zahra Hamzeh, R.PH

  • Pharmacist
  • Dearborn, MI
  • NPI 1497778674
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1502668800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1534204800000",
    "number": "1053836874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10437 W WARREN AVE",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481261660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10437 W WARREN AVE",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "48126",
            "telephone_number": "313-582-1670",
            "fax_number": "313-582-0707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LA VITA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-14",
        "last_updated": "2018-08-14",
        "status": "A",
        "authorized_official_last_name": "MOUSSAWEL",
        "authorized_official_first_name": "AZZAM",
        "authorized_official_title_or_position": "PHARM.D.",
        "authorized_official_telephone_number": "734-718-3705"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hamzeh Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Retail Pharmacy in Dearborn, MI
• Providers in Dearborn, MI by specialty
• Community/Retail Pharmacy in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.