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NPI Code Detail

MEDICARE: JASMINE JAMOUA

MEDICARE: JASMINE JAMOUA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist5302043281MI

General Provider Information

NPI Number : 1386152288
Entity Type Code : Individual
Provider Name (Legal Business Name) : JASMINE JAMOUA
Provider Business Mailing Address
First Line : 5400 PERRY DR
Second Line :
City : WATERFORD
State : MI
Zip : 48329-3461
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 5400 PERRY DR
Second Line :
City : WATERFORD
State : MI
Zip : 48329-3461
Country : US
Telephone Number : 248-674-7963
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/14/2018
Last Update Date : 01/14/2018

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Directions to “ JASMINE JAMOUA ” Practice Location

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