Healthcare Provider Details

I. General information

NPI: 1073002382
Provider Name (Legal Business Name): REEMAH HARB
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/02/2018
Last Update Date: 05/02/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

37140 47TH ST E
PALMDALE CA
93552-4450
US

IV. Provider business mailing address

37140 47TH ST E
PALMDALE CA
93552-4450
US

V. Phone/Fax

Practice location:
  • Phone: 661-533-1029
  • Fax: 661-533-1763
Mailing address:
  • Phone: 661-533-1029
  • Fax: 661-533-1763

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number52565
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: