Individual provider Active NPI

Allie Habhab, PHARMD

  • Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
  • Allen Park, MI
National Provider Identifier
1477189082
Registry record updated Mar 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistTaxonomy code 1835P0018X
License
5302043550 Issued in MI
Practice address
3100 Fairlane Dr
Allen Park, MI 48101-2870
Phone
(313) 765-0005
NPI assigned
Mar 14, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X 5302043550 MI Primary

Addresses

Primary practice location

3100 Fairlane Dr
Allen Park, MI 48101-2870

Mailing address

22178 Beech St
Dearborn, MI 48124-2702
Phone (313) 456-5565

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
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
5302043550MIMDPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist

NPI Registry JSON

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

{
    "created_epoch": "1584144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584144000000",
    "number": "1477189082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22178 BEECH ST",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481242702",
            "telephone_number": "313-456-5565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 FAIRLANE DR",
            "city": "ALLEN PARK",
            "state": "MI",
            "postal_code": "481012870",
            "telephone_number": "313-765-0005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HABHAB",
        "first_name": "ALLIE",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-14",
        "last_updated": "2020-03-14",
        "certification_date": "2020-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "MI",
            "license": "5302043550",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Allen Park, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2020; 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.