Fadi Fardous, RPH

Key facts

NPI

1366907982

Entity type

Individual (NPI type 1)

Primary specialty

Pharmacist 183500000X

License

5302032100 (MI)

Practice address

19401 Hubbard Dr
Dearborn, MI 48126-2641

Phone

(313) 982-8245

NPI assigned

Feb 7, 2019

Sex

Male

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

Credentials

Registered Pharmacist

State licenses

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on May 9, 2019.

{
    "created_epoch": "1549497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557360000000",
    "number": "1366907982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5454 KENDAL ST",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481263158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19401 HUBBARD DR",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481262641",
            "telephone_number": "313-982-8245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FARDOUS",
        "first_name": "FADI",
        "name_prefix": "Mr.",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-02-07",
        "last_updated": "2019-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MI",
            "license": "5302032100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dearborn, MI

• Samar Faraj, D.D.S.
• Zeinab Faraj
• Ziyad Faraj
• Corey Scott Farber, D.D.S.
• Robert Michael Farber, D.D.S.
• Mahmoud Fardous
• Fares Yasin
• Abdelkader Hassan Fares, M.D
• Fredaz Fares, NP
• Haytham A Fares, D.D.S.

All providers in Dearborn, MI · Pharmacist in Michigan