=====================================================
General NPI Number Information
=====================================================
NPI Number | 1942735337
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MOUMITA RINKI
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/24/2017
-----------------------------------------------------
Last Update Date | 01/28/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 16000 E 10 MILE RD
-----------------------------------------------------
City | EASTPOINTE
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 48021-1101
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 586-777-7570
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3439 YEMANS ST
-----------------------------------------------------
City | HAMTRAMCK
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 48212-3317
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 313-231-6220
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 183500000X
-----------------------------------------------------
Taxonomy Name | Pharmacist
-----------------------------------------------------
License Number | 5302042716
-----------------------------------------------------
License Number State | MI
-----------------------------------------------------