Healthcare Provider Details

I. General information

NPI: 1912950163
Provider Name (Legal Business Name): IRWIN RABINOWITZ RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 05/18/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

JUNCTION CLINIC PHARMACY 4771 MICHIGAN AVE.
DETROIT MI
48210
US

IV. Provider business mailing address

JUNCTION CLINIC PHARMACY 4771 MICHIGAN AVE.
DETROIT MI
48210
US

V. Phone/Fax

Practice location:
  • Phone: 313-898-6946
  • Fax: 313-897-2424
Mailing address:
  • Phone: 313-898-6946
  • Fax: 313-897-2424

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number5302018933
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: