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NPI Code Detail

MEDICARE: DR. SAMANTHA FAITH QUAIL PHARMD

MEDICARE: DR. SAMANTHA FAITH QUAIL 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
1183500000XPharmacist5302411992MI

General Provider Information

NPI Number : 1609423565
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SAMANTHA FAITH QUAIL PHARMD
Provider Business Mailing Address
First Line : 33510 SCHOOLCRAFT RD
Second Line :
City : LIVONIA
State : MI
Zip : 48150-1504
Country : US
Telephone Number : 734-422-3310
Fax Number :
Provider Business Practice Location Address
First Line : 1815 ROCHESTER RD
Second Line :
City : ROYAL OAK
State : MI
Zip : 48073-4136
Country : US
Telephone Number : 248-546-6572
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/24/2019
Last Update Date : 08/28/2020

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