LONG LIFE PHARMACY 2 LLC (NPI# 1497355002) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497355002 |
| Entity Type | Organization |
| Organization Name | LONG LIFE PHARMACY 2 LLC |
| Practice Address |
1225 W Historic Mitchell St Ste 217 Milwaukee WI 53204-3382 |
| Mailing Address |
1521 W Edgerton Ave Unit B Milwaukee WI 53221-3561 |
| Practice Telephone | 4143756112 |
| Practice Fax Number | 4143756113 |
| Mailing Telephone | 4143260888 |
| Mailing Fax Number | 4143756113 |
| Enumeration Date | 2020-11-01 |
| Last Update Date | 2020-11-01 |
| Authorized Official Name | DR. MOATH SARSOUR (OWNER AND PHARMACIST) |
| Authorized Official Telephone | 4143260888 |
| Authorized Official Credential | PHARMD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 333600000X | Pharmacy | Suppliers |
| Other Name | Type Code |
|---|---|
| Long Life Pharmacy 2 | Doing Business As Name - Organization |
| Street Address |
1225 W HISTORIC MITCHELL ST STE 217 |
| City | MILWAUKEE |
| State | WI |
| Zip Code | 53204-3382 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528423290 | Blue Ribbon Healthcare LLC | Health Maintenance Organization | 1743 South1st Street, Milwaukee, WI 53204 | 2015-12-23 |
| 1215336599 | Marsha Vann | Counselor | 1028 N 9th St, Milwaukee, WI 53204 | 2014-08-22 |
| 1891109260 | Melissa Bendever | Counselor | 1111 South 6th Street, Milwaukee, WI 53204 | 2014-06-13 |
| 1942585823 | Theresa Marie Hintze | Counselor | 600 W Virginia Atlas Ste 203, Milwaukee, WI 53204 | 2011-10-11 |
| 1922395151 | Palmas & Ram Rudra LLC | Chiropractor | 1247 S. Cesar E. Chaves Drive, Milwaukee, WI 53204 | 2011-07-08 |
| 1225355183 | Victoria A White | Family Medicine | 16th Street Community Health Center, 1032 S Cesar E. Chavez Drive, Milwaukee, WI 53204 | 2010-04-30 |
| 1174850499 | Dnt Associates Inc. | Dentist | 710 W. Historic Mitchell St., Mitchell Street Dental, Milwaukee, WI 53204 | 2009-11-06 |
| 1851559124 | Michael L Kitzinger | Social Worker | 1201 W Historic Mitchell St, Milwaukee, WI 53204 | 2008-05-23 |
| 1083778781 | Douglas Ralph Higbie | Psychologist | 634 W Mitchell St, Milwaukee, WI 53204 | 2006-12-20 |
| 1013019413 | Romeo C Lo Md | Internal Medicine | 1672 S 9th St, 2nd Floor, Milwaukee, WI 53204 | 2006-09-05 |
| Find all providers in zip 53204 | ||||
| Taxonomy Code | 333600000X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: added definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790333623 | Froedtert Health Pharmacy LLC | Pharmacy | 9200 W Wisconsin Ave Ste 200w, Milwaukee, WI 53226-3522 | 2019-09-04 |
| 1225686405 | Froedtert Health Pharmacy LLC | Pharmacy | 9200 W Wisconsin Ave Ste 200c, Milwaukee, WI 53226-3522 | 2019-08-30 |
| 1093287237 | Del Mar Pharmacy Sc | Pharmacy | 1000 S Cesar E Chavez Dr, Milwaukee, WI 53204-2203 | 2018-12-28 |
| 1154805422 | Wellnessscriptrx | Pharmacy | 159 N Jackson St Ste 105, Milwaukee, WI 53202-6169 | 2018-09-21 |
| 1437672797 | Life Change Rx LLC | Pharmacy | 1844 S 15th St, Milwaukee, WI 53204-3225 | 2017-07-19 |
| 1265965198 | Hayat Pharmacy 10 LLC | Pharmacy | 5308 W Burleigh St, Milwaukee, WI 53210-1622 | 2017-04-07 |
| 1053766071 | Hayat Pharmacy 9 LLC | Pharmacy | 8434 W Silver Spring Dr, Milwaukee, WI 53225-2824 | 2016-04-27 |
| 1780039024 | Medpack Pharmacy | Pharmacy | 7324 W Capitol Dr, Milwaukee, WI 53216-2062 | 2016-04-24 |
| 1972989861 | Walgreens | Pharmacy | 3528 S Clement Ave, Milwaukee, WI 53207-3502 | 2015-08-03 |
| 1477688406 | Aurora Pharmacy, Inc. | Pharmacy | 4061 N 54th St, Milwaukee, WI 53216-1377 | 2007-02-22 |
| Find all providers in MILWAUKEE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.