Healthcare Provider Details

I. General information

NPI: 1932881026
Provider Name (Legal Business Name): HUSSEIN HARAJLY PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/07/2023
Last Update Date: 01/06/2026
Certification Date: 01/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13720 E 12 MILE RD
WARREN MI
48088-3751
US

IV. Provider business mailing address

13720 E 12 MILE RD
WARREN MI
48088-3751
US

V. Phone/Fax

Practice location:
  • Phone: 586-362-8404
  • Fax:
Mailing address:
  • Phone: 586-307-5036
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number5302416748
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: