Long Life Pharmacy LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

LONG LIFE PHARMACY LLC

Practice address

1672 S 9TH St Unit D
Milwaukee, WI 53204-3426

Phone

(414) 326-0888

NPI assigned

Jun 12, 2019

Organization subpart

No

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

Authorized official

Name

Dr. Moath M Sarsour, PH-D

Title

Owner

Phone

(414) 375-6112

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Practitioners 1

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

• Ahmad H Idriss, RPH

  • Pharmacist
  • Milwaukee, WI
  • NPI 1750032892
  NPD (past)

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

{
    "created_epoch": "1560297600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1782172800000",
    "number": "1699334532",
    "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": "414-375-6112",
            "fax_number": "414-375-6113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1672 S 9TH ST UNIT D",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532043426",
            "telephone_number": "414-326-0888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LONG LIFE PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-06-12",
        "last_updated": "2026-06-23",
        "certification_date": "2026-06-23",
        "status": "A",
        "authorized_official_last_name": "SARSOUR",
        "authorized_official_first_name": "MOATH",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "414-375-6112",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH-D"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Richard L London, M.D.
• Shelley London, MSW
• Londynns Bridge Afh LLC
• Edna Lonergan, OTR
• Sydoney Alicia Loney, RN
• Long Life Pharmacy LTC
• Long SN Lee, D.D.S.,S.C.
• Amanda Long, MS, LPC-IT, NCC
• Cheryl Denise Long, LPN
• Christopher M Long, MD

• Community/Retail Pharmacy in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• Community/Retail Pharmacy in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2026; 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.