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NPI Code Detail

MEDICARE: MRS. AMNA IMAD MOHAMMAD RPH

MEDICARE: MRS. AMNA IMAD MOHAMMAD RPH
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist5302412375MI

General Provider Information

NPI Number : 1023778552
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. AMNA IMAD MOHAMMAD RPH
Provider Business Mailing Address
First Line : 1150 MYSTIC FOREST CT
Second Line :
City : CANTON
State : MI
Zip : 48187-2735
Country : US
Telephone Number : 248-719-2314
Fax Number :
Provider Business Practice Location Address
First Line : 13031 CONANT ST
Second Line :
City : DETROIT
State : MI
Zip : 48212-2361
Country : US
Telephone Number : 313-893-3339
Fax Number : 313-893-3337
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/24/2021
Last Update Date : 12/24/2021

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Directions to “ MRS. AMNA IMAD MOHAMMAD RPH” Practice Location

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