Healthcare Provider Details

I. General information

NPI: 1609781897
Provider Name (Legal Business Name): LINH PHAM PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/14/2026
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15420 19 MILE RD
CLINTON TOWNSHIP MI
48038-6339
US

IV. Provider business mailing address

51221 SCHOENHERR RD STE 201
SHELBY TOWNSHIP MI
48315-2718
US

V. Phone/Fax

Practice location:
  • Phone: 586-263-3400
  • Fax:
Mailing address:
  • Phone: 586-323-4450
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P2201X
TaxonomyAmbulatory Care Pharmacist
License Number5302416549
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: