Healthcare Provider Details

I. General information

NPI: 1790399962
Provider Name (Legal Business Name): REFAELA BEQI PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/03/2020
Last Update Date: 09/03/2020
Certification Date: 09/03/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27050 JOHN R RD
MADISON HEIGHTS MI
48071-3326
US

IV. Provider business mailing address

8234 INDEPENDENCE DR
STERLING HEIGHTS MI
48313-3828
US

V. Phone/Fax

Practice location:
  • Phone: 248-547-0800
  • Fax:
Mailing address:
  • Phone: 586-718-9992
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number5302412880
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: