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General NPI Number Information
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NPI Number | 1366690117
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Entity Type | Individual
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Provider Name | GHADA BANOUB RPH
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Gender | Female
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Dates
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Enumeration Date | 09/05/2008
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Last Update Date | 09/05/2008
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Provider Practice Location Address
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Address Line | 114 S BYRNE RD
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City | TOLEDO
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State | OH
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Zip | 43615-6213
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Country | US
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Telephone | 419-535-0069
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Fax | 419-535-3212
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Provider Business Mailing Address
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Address Line | 2817 SPRING WATER DR
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City | TOLEDO
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State | OH
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Zip | 43617-1369
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Country | US
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Telephone | 419-843-9550
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Fax | 419-841-9550
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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 | 03221512
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License Number State | OH
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