MEDICARE: DR. ALI HASSAN CHEHAB PHARMD

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
1	183500000X	Pharmacist	5302040613	MI

General Provider Information

NPI Number	:	1417380353
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALI HASSAN CHEHAB PHARMD

Provider Business Mailing Address
First Line	:	5801 CALHOUN ST
Second Line	:
City	:	DEARBORN
State	:	MI
Zip	:	48126-2237
Country	:	US
Telephone Number	:	313-415-6078
Fax Number	:

Provider Business Practice Location Address
First Line	:	3270 GREENFIELD RD STE 101
Second Line	:
City	:	BERKLEY
State	:	MI
Zip	:	48072-1161
Country	:	US
Telephone Number	:	248-284-6969
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/14/2013
Last Update Date	:	02/06/2020

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