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General NPI Number Information
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NPI Number | 1477171189
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Entity Type | Individual
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Provider Name | RIMA MOHAMMAD FARDOS PHARM.D.
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Gender | Female
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Dates
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Enumeration Date | 07/09/2020
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Last Update Date | 11/30/2023
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Provider Practice Location Address
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Address Line | 25486 CLAIRVIEW DR
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City | DEARBORN HEIGHTS
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State | MI
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Zip | 48127-3803
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Country | US
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Telephone | 201-414-6013
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Fax |
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Provider Business Mailing Address
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Address Line | 25486 CLAIRVIEW DR
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City | DEARBORN HEIGHTS
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State | MI
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Zip | 48127-3803
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Country | US
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Telephone | 120-141-4601
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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 | 5302044844
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License Number State | MI
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