Healthcare Provider Details

I. General information

NPI: 1881505543
Provider Name (Legal Business Name): SAMI K SHIMOON RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/14/2026
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4617 THE HEIGHTS BLVD
ROCHESTER MI
48306-4955
US

IV. Provider business mailing address

4617 THE HEIGHTS BLVD
ROCHESTER MI
48306-4955
US

V. Phone/Fax

Practice location:
  • Phone: 248-790-2790
  • Fax: 586-776-6551
Mailing address:
  • Phone: 248-790-2790
  • Fax: 586-776-6551

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number5302026825
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: