Lifetime Pharmacy, LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

LIFETIME PHARMACY, LLC

Practice address

212 W Edison Rd Ste a
Mishawaka, IN 46545-8301

Phone

(313) 828-2794

NPI assigned

Jul 10, 2024

Organization subpart

No

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

Authorized official

Name

Hassan Fakih, PHARMDNPI 1083360671

Title

Owner

Phone

(313) 828-2794

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IN2 enrollments

Enrollment records 2

Tax ID family

Lifetime Pharmacy LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Lifetime Pharmacy, LLC

  • Long Term Care Pharmacy
  • Mishawaka, IN
  • NPI 1831998467
  NPD tax ID

Locations

Practitioners 1

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

• Hassan Fakih

  • Pharmacist
  • South Bend, IN
  • NPI 1083360671
  NPD Authorized official

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

{
    "created_epoch": "1720569600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1720569600000",
    "number": "1750128401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "212 W EDISON RD STE A",
            "city": "MISHAWAKA",
            "state": "IN",
            "postal_code": "465458301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "212 W EDISON RD STE A",
            "city": "MISHAWAKA",
            "state": "IN",
            "postal_code": "465458301",
            "telephone_number": "313-828-2794"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFETIME PHARMACY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-10",
        "last_updated": "2024-07-10",
        "certification_date": "2024-07-10",
        "status": "A",
        "authorized_official_last_name": "FAKIH",
        "authorized_official_first_name": "HASSAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "313-828-2794",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Izaak J Lewis
• Anita Li, MD
• Libby Lake Counseling LLC
• Emma Grace Lichtenbarger
• Life in Balance LLC
• Lifetime Pharmacy, LLC
• Carianne Nicole Lilly, DPM
• Lloyd Bolivar Limbaga Jr., P.T.
• Jamie Limberty
• Kyle G Lindberg, OD

• Community/Retail Pharmacy in Mishawaka, IN
• Providers in Mishawaka, IN by specialty
• Community/Retail Pharmacy in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 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.