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General NPI Number Information
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NPI Number | 1912501685
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Entity Type | Individual
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Provider Name | NABIL HENEIN
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Gender | Male
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Dates
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Enumeration Date | 11/24/2020
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Last Update Date | 11/24/2020
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Provider Practice Location Address
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Address Line | 1124 N BALLENGER HWY
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City | FLINT
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State | MI
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Zip | 48504-7516
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Country | US
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Telephone | 810-233-6765
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Fax |
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Provider Business Mailing Address
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Address Line | 3982 FORSTER LN
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City | SHELBY TWP
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State | MI
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Zip | 48316-3892
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Country | US
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Telephone | 586-480-3201
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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 | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 5302032880
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License Number State | MI
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