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NPI Code Detail

MEDICARE: NASHWA GERGES-HENAN PHARMACIST

MEDICARE: NASHWA GERGES-HENAN PHARMACIST
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
1183500000XPharmacist5302037696MI

General Provider Information

NPI Number : 1184240699
Entity Type Code : Individual
Provider Name (Legal Business Name) : NASHWA GERGES-HENAN PHARMACIST
Provider Business Mailing Address
First Line : 49668 SANDRA DR
Second Line :
City : SHELBY TWP
State : MI
Zip : 48315-3537
Country : US
Telephone Number : 586-354-0059
Fax Number :
Provider Business Practice Location Address
First Line : 45400 MARKETPLACE BLVD
Second Line :
City : CHESTERFIELD
State : MI
Zip : 48051-3279
Country : US
Telephone Number : 586-421-1265
Fax Number : 586-421-1267
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/20/2020
Last Update Date : 06/20/2020

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