Provider Demographics
NPI:1548514847
Name:L A PHARMACY INC.
Entity type:Organization
Organization Name:L A PHARMACY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:
Authorized Official - Last Name:GILEZAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-581-6100
Mailing Address - Street 1:7237 CHASE RD
Mailing Address - Street 2:
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48126-1301
Mailing Address - Country:US
Mailing Address - Phone:313-581-6100
Mailing Address - Fax:313-581-6500
Practice Address - Street 1:7237 CHASE RD
Practice Address - Street 2:
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48126-1301
Practice Address - Country:US
Practice Address - Phone:313-581-6100
Practice Address - Fax:313-581-6500
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-08
Last Update Date:2012-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy