Active NPI
Hassan Dakroub
- Pharmacist
- Lincoln Park, MI
National Provider Identifier
1457835779
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 5302044388
- Practice address
- 1765 Fort St
Lincoln Park, MI 48146-1901 - Phone
- (313) 928-8638
- NPI assigned
- Sep 21, 2018
- Reactivated
- Jun 14, 2022
- Last updated
- Jun 14, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 5302044388 | MI | Primary |
Addresses
Primary practice location
1765 Fort St
Lincoln Park, MI 48146-1901
Mailing address
1624 N Vernon St
Dearborn, MI 48128-2504
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5302044388 | MI | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Organizations & group practices 2
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": "1537488000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1655164800000",
"number": "1457835779",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1624 N VERNON ST",
"city": "DEARBORN",
"state": "MI",
"postal_code": "481282504"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1765 FORT ST",
"city": "LINCOLN PARK",
"state": "MI",
"postal_code": "481461901",
"telephone_number": "313-928-8638"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAKROUB",
"first_name": "HASSAN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-09-21",
"last_updated": "2022-06-14",
"certification_date": "2022-06-14",
"deactivation_date": "2019-10-09",
"reactivation_date": "2022-06-14",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MI",
"license": "5302044388",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lincoln Park, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.