Healthcare Provider Details

I. General information

NPI: 1427964774
Provider Name (Legal Business Name): SANTINA SABAH PATTAH PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/19/2026
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40925 GARFIELD RD
CLINTON TOWNSHIP MI
48038-2537
US

IV. Provider business mailing address

2111 E SHORE DR
ROCHESTER HILLS MI
48307-4329
US

V. Phone/Fax

Practice location:
  • Phone: 586-263-4070
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number5302419212
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: