Lifesmart Pharmacy LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

LIFESMART PHARMACY LLC

Practice address

2176 Fort St
Lincoln Park, MI 48146-2405

Phone

(313) 768-5858

Fax

(313) 768-5868

NPI assigned

Sep 19, 2018

Organization subpart

No

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

Authorized official

Name

Adham Mallah

Title

Owner/President

Phone

(313) 478-7823

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1537315200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1694131200000",
    "number": "1104300862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2176 FORT ST",
            "city": "LINCOLN PARK",
            "state": "MI",
            "postal_code": "481462405",
            "telephone_number": "313-768-5096",
            "fax_number": "313-768-5098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2176 FORT ST",
            "city": "LINCOLN PARK",
            "state": "MI",
            "postal_code": "481462405",
            "telephone_number": "313-768-5858",
            "fax_number": "313-768-5868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFESMART PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-09-19",
        "last_updated": "2023-09-08",
        "certification_date": "2023-09-08",
        "status": "A",
        "authorized_official_last_name": "MALLAH",
        "authorized_official_first_name": "ADHAM",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "313-478-7823"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Angelika Lewis, LSW
• James P. Lewis, LMSW
• John Lewis, L.M.S.W.
• Lifeline Concord LLC
• Lifesmart Medical Center PLLC
• Lincoln DME Care Supply LLC
• Lincoln Park Dental Associates
• Lincoln Park Family Dentistry DDS PC
• Lincoln Park Health Management
• Lincoln Park Kidney Center LLC

• Community/Retail Pharmacy in Lincoln Park, MI
• Providers in Lincoln Park, 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 Sep 8, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.