Healthcare Provider Details

I. General information

NPI: 1154244739
Provider Name (Legal Business Name): GHARRAM HAMED MASHRAH PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/31/2026
Last Update Date: 07/31/2026
Certification Date: 07/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1191 SOUTH BLVD E
ROCHESTER HILLS MI
48307-5453
US

IV. Provider business mailing address

6157 MIDDLESEX ST
DEARBORN MI
48126-2169
US

V. Phone/Fax

Practice location:
  • Phone: 800-456-2112
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number5302419110
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: