=====================================================
General NPI Number Information
=====================================================
NPI Number | 1730785619
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | AHMED SAID PHARM D
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/07/2020
-----------------------------------------------------
Last Update Date | 12/07/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 8665 ROSA PARKS BLVD
-----------------------------------------------------
City | DETROIT
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 48206-2299
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 313-361-8800
-----------------------------------------------------
Fax | 313-361-8875
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 8665 ROSA PARKS BLVD
-----------------------------------------------------
City | DETROIT
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 48206-2299
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 313-361-8800
-----------------------------------------------------
Fax | 313-361-8875
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 183500000X
-----------------------------------------------------
Taxonomy Name | Pharmacist
-----------------------------------------------------
License Number | 5302033669
-----------------------------------------------------
License Number State | MI
-----------------------------------------------------