Ghada Abdallah, RPH

Individual provider Active NPI Pharmacist · Grosse Pointe Park, MI

NPI 1740414903 · NPPES record last updated Feb 24, 2012

Key facts

NPI
1740414903
Entity type
Individual (NPI type 1)
Primary specialty
Pharmacist 183500000X
License
5302032699 (MI)
Practice address
15126 Kercheval Ave
Grosse Pointe Park, MI 48230-1360
Phone
(313) 822-0100
Fax
(313) 822-0101
NPI assigned
May 3, 2009
Sex
Female
Sole proprietor
Yes

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 and National Provider Directory roles.

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

LicenseStateTypeSpecialty
5302032699MIMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Park Pharmacy Inc Current Accepting new patients
Park Pharmacy SCS LLC Current Accepting new patients

Locations

15126 Kercheval Ave
Grosse Pointe Park, MI 48230
Phone (313) 822-0100

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 5302032699 MI Yes

Addresses

Primary practice location

15126 Kercheval Ave
Grosse Pointe Park, MI 48230-1360

Mailing address

15126 Kercheval Ave
Grosse Pointe Park, MI 48230-1360
Phone (313) 822-0100

Other providers in Grosse Pointe Park, MI

All providers in Grosse Pointe Park, MI · Pharmacist in Michigan

Sources for this page

Verify at the official NPI Registry.