Healthcare Provider Details

I. General information

NPI: 1699696120
Provider Name (Legal Business Name): ANN AMARACHI MARK PHARM.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/22/2026
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6400 ROYAL POINTE DR
WEST BLOOMFIELD MI
48322-4803
US

IV. Provider business mailing address

6400 ROYAL POINTE DR
WEST BLOOMFIELD MI
48322-4803
US

V. Phone/Fax

Practice location:
  • Phone: 248-202-9984
  • Fax:
Mailing address:
  • Phone: 248-202-9984
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number5302418397
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: