Healthcare Provider Details

I. General information

NPI: 1780508309
Provider Name (Legal Business Name): HUSSEIN RAYCHOUNI PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/06/2026
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6610 FENTON ST
DEARBORN HEIGHTS MI
48127-2151
US

IV. Provider business mailing address

6610 FENTON ST
DEARBORN HEIGHTS MI
48127-2151
US

V. Phone/Fax

Practice location:
  • Phone: 313-673-4412
  • Fax:
Mailing address:
  • Phone: 313-673-4412
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number5302419182
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: