Healthcare Provider Details

I. General information

NPI: 1619832763
Provider Name (Legal Business Name): HAI TEAM LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/22/2025
Last Update Date: 12/22/2025
Certification Date: 12/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1170 W FRONT ST
MONROE MI
48161-2465
US

IV. Provider business mailing address

1170 W FRONT ST
MONROE MI
48161-2465
US

V. Phone/Fax

Practice location:
  • Phone: 734-799-9000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number
License Number State

VIII. Authorized Official

Name: ISSA KAKISH
Title or Position: PHARMACIST IN CHARGE
Credential: PHARMD
Phone: 586-216-1023