Healthcare Provider Details

I. General information

NPI: 1447880091
Provider Name (Legal Business Name): REEM ALJANABI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/23/2020
Last Update Date: 01/18/2024
Certification Date: 01/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

510 E 3RD ST APT 420
POMONA CA
91766-1904
US

IV. Provider business mailing address

562 MCKINLEY CIR
CANTON MI
48188-6688
US

V. Phone/Fax

Practice location:
  • Phone: 301-655-5467
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P2201X
TaxonomyAmbulatory Care Pharmacist
License Number5302414093
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: