Healthcare Provider Details

I. General information

NPI: 1881432417
Provider Name (Legal Business Name): SYLVANIA FAMILY PHARMACY MONROE ST LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/17/2024
Last Update Date: 05/16/2025
Certification Date: 05/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5412 MONROE ST STE 1
TOLEDO OH
43623-2890
US

IV. Provider business mailing address

5412 MONROE ST STE 1
TOLEDO OH
43623-2890
US

V. Phone/Fax

Practice location:
  • Phone: 419-517-0006
  • Fax: 419-517-0008
Mailing address:
  • Phone: 419-517-0006
  • Fax: 419-517-0008

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: DR. ABDUL HASSAN EL KHATIB
Title or Position: OWNER
Credential:
Phone: 419-386-6622