Healthcare Provider Details

I. General information

NPI: 1235762444
Provider Name (Legal Business Name): OLA MUKHTAR RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/16/2020
Last Update Date: 05/12/2026
Certification Date: 05/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

43893 SCHOENHERR RD
STERLING HEIGHTS MI
48313-1119
US

IV. Provider business mailing address

43893 SCHOENHERR RD
STERLING HEIGHTS MI
48313-1119
US

V. Phone/Fax

Practice location:
  • Phone: 586-685-1346
  • Fax:
Mailing address:
  • Phone: 586-685-1346
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number5302412209
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: