Healthcare Provider Details

I. General information

NPI: 1164036364
Provider Name (Legal Business Name): MRS. SELVA FRANCIS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/04/2020
Last Update Date: 09/04/2020
Certification Date: 09/04/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3521 CORUNNA RD
FLINT MI
48503-3267
US

IV. Provider business mailing address

35144 SAVANNAH CT
FARMINGTON HILLS MI
48331-3200
US

V. Phone/Fax

Practice location:
  • Phone: 810-235-6363
  • Fax:
Mailing address:
  • Phone: 248-949-5711
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number5302412341
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: