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General NPI Number Information
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NPI Number | 1255962395
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Entity Type | Individual
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Provider Name | LOUBNA BAZZI BADREDDINE RPH
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Gender | Female
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Dates
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Enumeration Date | 01/28/2020
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Last Update Date | 03/06/2020
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Provider Practice Location Address
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Address Line | 15325 MICHIGAN AVE
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City | DEARBORN
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State | MI
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Zip | 48126-2954
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Country | US
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Telephone | 313-582-9422
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Fax |
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Provider Business Mailing Address
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Address Line | 714 CENTRALIA ST
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City | DEARBORN HEIGHTS
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State | MI
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Zip | 48127-3720
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Country | US
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Telephone | 313-409-6102
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 5302410865
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License Number State | MI
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