NPI 1053836874
La Vita LLC
Practice location
- Address
- 10437 W Warren Ave, Dearborn, MI 48126
- Phone
- (313) 582-1670
- Fax
- (313) 582-0707
- Mailing address
- 10437 W Warren Ave, Dearborn, MI 48126-1660
Authorised official
- Name
- Azzam Moussawel
- Title
- Pharm.D.
- Phone
- (734) 718-3705
Registered specialties
Community/Retail Pharmacy
Primary
Registry record
- NPI
- 1053836874
- Entity type
- Organization
- NPI issued
- 14 Aug 2017
- Record last updated
- 14 Aug 2018
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.