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General NPI Number Information
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NPI Number | 1275792384
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Entity Type | Individual
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Provider Name | ROD HANI ODISH RPH
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Gender | Male
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Dates
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Enumeration Date | 06/03/2008
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Last Update Date | 06/03/2008
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Provider Practice Location Address
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Address Line | 3050 UNION LAKE RD
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City | COMMERCE TWP
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State | MI
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Zip | 48382-4509
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Country | US
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Telephone | 248-363-4392
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Fax | 248-363-7223
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Provider Business Mailing Address
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Address Line | 3050 UNION LAKE RD
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City | COMMERCE TWP
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State | MI
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Zip | 48382-4509
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Country | US
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Telephone | 248-363-4392
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Fax | 248-363-7223
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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 | 5302031051
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License Number State | MI
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