Long Life Pharmacy 2 LLC

Primary specialty

PharmacyTaxonomy code 333600000X

Legal business name

LONG LIFE PHARMACY 2 LLC

Practice address

932 S 60TH St
West Allis, WI 53214-3369

Phone

(414) 375-6112

Fax

(414) 375-6113

NPI assigned

Nov 1, 2020

Organization subpart

No

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

Authorized official

Name

Dr. Moath Sarsour, PHARMD

Title

Owner and Pharmacist

Phone

(414) 377-7717

Specialties & licenses 1

Addresses

Other names 1

• Long Life Pharmacy 2 Doing business as

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Locations

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

{
    "created_epoch": "1604188800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712188800000",
    "number": "1497355002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1255 E HICKORY CREEK CT",
            "city": "OAK CREEK",
            "state": "WI",
            "postal_code": "531547316",
            "telephone_number": "414-377-7717",
            "fax_number": "414-377-7719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "932 S 60TH ST",
            "city": "WEST ALLIS",
            "state": "WI",
            "postal_code": "532143369",
            "telephone_number": "414-375-6112",
            "fax_number": "414-375-6113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LONG LIFE PHARMACY 2 LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-11-01",
        "last_updated": "2024-04-04",
        "certification_date": "2024-04-04",
        "status": "A",
        "authorized_official_last_name": "SARSOUR",
        "authorized_official_first_name": "MOATH",
        "authorized_official_title_or_position": "OWNER AND PHARMACIST",
        "authorized_official_telephone_number": "414-377-7717",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Long Life Pharmacy 2",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Long Life Pharmacy 2",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Anni Liu
• LL West Allis, LLC
• Lisa B. Lloyd
• Justin Loeper, DPT
• Suzanna Logan, M.D., PH.D.
• Josie Longhorn, DPT
• Jackie Loomis, RN
• Gena Lorbecki, RPH
• Bonnie June Loreti, RN
• Laurie Ann Lorino, CSAC

• Pharmacy in West Allis, WI
• Providers in West Allis, WI by specialty
• Pharmacy in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2024; 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.