Provider Demographics
NPI:1396753877
Name:JOSEPH A LANZON RPH PC
Entity type:Organization
Organization Name:JOSEPH A LANZON RPH PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AAMIR
Authorized Official - Middle Name:
Authorized Official - Last Name:UDDIN
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:734-427-2400
Mailing Address - Street 1:11589 FARMINGTON RD
Mailing Address - Street 2:
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48150-5729
Mailing Address - Country:US
Mailing Address - Phone:734-427-2400
Mailing Address - Fax:734-261-6139
Practice Address - Street 1:11589 FARMINGTON RD
Practice Address - Street 2:
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48150-5729
Practice Address - Country:US
Practice Address - Phone:734-427-2400
Practice Address - Fax:734-261-6139
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-03
Last Update Date:2024-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
3336L0003X
MI53010049753336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2040502OtherPK
MI2915057Medicaid
MI2915066Medicaid
2040502OtherPK