MEDICARE: MRS. BAIDA N KASHAT RPH

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	5302027858	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	5302027858	OTHER	MI	PHARMACIST LICENSE NUMBER

General Provider Information

NPI Number	:	1841371325
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. BAIDA N KASHAT RPH

Provider Business Mailing Address
First Line	:	34644 DEQUINDRE RD
Second Line	:
City	:	STERLING HEIGHTS
State	:	MI
Zip	:	48310-5233
Country	:	US
Telephone Number	:	248-858-3054
Fax Number	:

Provider Business Practice Location Address
First Line	:	34644 DEQUINDRE RD
Second Line	:
City	:	STERLING HEIGHTS
State	:	MI
Zip	:	48310-5233
Country	:	US
Telephone Number	:	248-858-3054
Fax Number	:

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

Provider Enumeration Date	:	10/18/2006
Last Update Date	:	01/31/2013

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