Healthcare Provider Details

I. General information

NPI: 1972916708
Provider Name (Legal Business Name): ARASH RAOOFI R.PH.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/10/2014
Last Update Date: 05/31/2026
Certification Date: 05/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 E BRISTOL RD
BURTON MI
48529-2522
US

IV. Provider business mailing address

1200 E BRISTOL RD
BURTON MI
48529-2522
US

V. Phone/Fax

Practice location:
  • Phone: 810-239-9941
  • Fax: 810-341-6471
Mailing address:
  • Phone: 810-239-9941
  • Fax: 810-341-6471

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number03126067
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number19387
License Number StateNV
# 3
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number5302032003
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: