MEDICARE: AHMED HASSAN ANKOUNI 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
1	183500000X	Pharmacist	5302031124	MI

General Provider Information

NPI Number	:	1356441026
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AHMED HASSAN ANKOUNI RPH

Provider Business Mailing Address
First Line	:	1411 WASHINGTON BLVD
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48226-1745
Country	:	US
Telephone Number	:	313-237-9000
Fax Number	:	313-237-9961

Provider Business Practice Location Address
First Line	:	1411 WASHINGTON BLVD
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48226-1745
Country	:	US
Telephone Number	:	313-237-9000
Fax Number	:	313-237-9961

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/23/2006
Last Update Date	:	03/21/2015

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