Healthcare Provider Details

I. General information

NPI: 1215716550
Provider Name (Legal Business Name): RANA AMER NOORI RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/26/2023
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21555 21 MILE RD
MACOMB MI
48044-2961
US

IV. Provider business mailing address

21555 21 MILE RD
MACOMB MI
48044-2961
US

V. Phone/Fax

Practice location:
  • Phone: 586-421-9877
  • Fax: 586-421-9886
Mailing address:
  • Phone: 586-421-9877
  • Fax: 586-421-9886

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number5302415420
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number5302415420
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: