Pure Life Pharmacy LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

PURE LIFE PHARMACY LLC

Practice address

1373 Dix Hwy
Lincoln Park, MI 48146-1346

Phone

(313) 467-0264

NPI assigned

Jun 2, 2025

Organization subpart

No

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

Authorized official

Name

Mr. Mohammed Ibrahim, PHARM.DNPI 1093035164

Title

Owner/Pic

Phone

(313) 467-0264

Specialties & licenses 1

Addresses

Practitioners 1

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

• Mohammed Ibrahim, PHARM.D

  • Pharmacist
  • Bloomfield, MI
  • NPI 1093035164
  NPD Authorized official

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

{
    "created_epoch": "1748822400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1748822400000",
    "number": "1629961297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "820 S PEMBERTON RD",
            "city": "BLOOMFIELD",
            "state": "MI",
            "postal_code": "483021443",
            "telephone_number": "313-467-0264"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1373 DIX HWY",
            "city": "LINCOLN PARK",
            "state": "MI",
            "postal_code": "481461346",
            "telephone_number": "313-467-0264"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PURE LIFE PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-06-02",
        "last_updated": "2025-06-02",
        "certification_date": "2025-06-02",
        "status": "A",
        "authorized_official_last_name": "IBRAHIM",
        "authorized_official_first_name": "MOHAMMED",
        "authorized_official_title_or_position": "OWNER/PIC",
        "authorized_official_telephone_number": "313-467-0264",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PHARM.D"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• 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 Jun 2, 2025; 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.