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General NPI Number Information
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NPI Number | 1346650140
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Entity Type | Individual
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Provider Name | JOY FAKHOURI PHARM.D.
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Gender | Female
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Dates
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Enumeration Date | 05/01/2014
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Last Update Date | 05/01/2014
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Provider Practice Location Address
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Address Line | 49900 GRAND RIVER AVE
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City | WIXOM
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State | MI
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Zip | 48393-3308
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Country | US
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Telephone | 248-449-8533
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Fax | 248-449-8565
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Provider Business Mailing Address
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Address Line | 36537 GARDNER ST
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City | LIVONIA
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State | MI
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Zip | 48152-2781
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Country | US
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Telephone | 248-996-5533
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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 | 1835P1200X
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Taxonomy Name | Pharmacotherapy Pharmacist
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License Number | 5302039401
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License Number State | MI
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