Healthcare Provider Details

I. General information

NPI: 1811266562
Provider Name (Legal Business Name): HANADI LEE THOMAS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/27/2011
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4350 DIXIE HWY RITE AID PHARMACY
WATERFORD MI
48329
US

IV. Provider business mailing address

4350 DIXIE HWY RITE AID PHARMACY
WATERFORD MI
48329
US

V. Phone/Fax

Practice location:
  • Phone: 248-674-0466
  • Fax:
Mailing address:
  • Phone: 248-674-0466
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number5302031585
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number5302031585
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: