1326743386 NPI number — DR. MERAL E-ABDULMENAM EBRAHEM PHARMACIST

Table of content: DR. MERAL E-ABDULMENAM EBRAHEM PHARMACIST (NPI 1326743386)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1326743386 NPI number — DR. MERAL E-ABDULMENAM EBRAHEM PHARMACIST

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
EBRAHEM
Provider First Name:
MERAL
Provider Middle Name:
E-ABDULMENAM
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PHARMACIST
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1326743386
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/31/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
19055 GILL RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LIVONIA
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48152-3051
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
313-333-8668
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
14300 N BECK RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PLYMOUTH
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48170-3377
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
877-689-8697
Provider Business Practice Location Address Fax Number:
734-354-5992
Provider Enumeration Date:
03/31/2023

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 183500000X , with the licence number:  5302414947 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com