Luna F Alfakhoury

Individual provider Active NPI Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist · Southgate, MI

NPI 1104463967 · NPPES record last updated Nov 28, 2019

Key facts

NPI
1104463967
Entity type
Individual (NPI type 1)
Primary specialty
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X
License
19157080652 (MI)
Practice address
16705 Fort St
Southgate, MI 48195-1442
Phone
(734) 286-9220
NPI assigned
Nov 28, 2019
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
19157080652MIMDPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X 19157080652 MI Yes

Addresses

Primary practice location

16705 Fort St
Southgate, MI 48195-1442

Mailing address

44478 Bayview Ave Apt 17211
Clinton TWP, MI 48038-7134
Phone (586) 846-7442

Other providers in Southgate, MI

All providers in Southgate, MI · Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in Michigan

Sources for this page

Verify at the official NPI Registry.