Individual provider Active NPI

Hassane Fadlallah, RPH

  • Pharmacist
  • Dearborn, MI
National Provider Identifier
1235677386
Registry record updated Mar 2, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
5302027840 Issued in MI
Practice address
10066 Dix
Dearborn, MI 48120-1551
Phone
(313) 843-2400
Fax
(313) 843-2402
NPI assigned
Feb 9, 2017
Last updated
Mar 2, 2017By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 2, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 5302027840 MI Primary

Addresses

Primary practice location

10066 Dix
Dearborn, MI 48120-1551

Mailing address

10066 Dix
Dearborn, MI 48120-1551
Phone (313) 843-2400

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
5302027840MIMDPharmacist

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1486598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488412800000",
    "number": "1235677386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10066 DIX",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481201551",
            "telephone_number": "313-843-2400",
            "fax_number": "313-843-2402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10066 DIX",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481201551",
            "telephone_number": "313-843-2400",
            "fax_number": "313-843-2402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FADLALLAH",
        "first_name": "HASSANE",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-02-09",
        "last_updated": "2017-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MI",
            "license": "5302027840",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dearborn, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.