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NPI Code Detail

MEDICARE: VANNA FACHOU

MEDICARE: VANNA FACHOU
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
1183500000XPharmacist5302411686MI

General Provider Information

NPI Number : 1548748767
Entity Type Code : Individual
Provider Name (Legal Business Name) : VANNA FACHOU
Provider Business Mailing Address
First Line : 14165 ELMHURST DR
Second Line :
City : STERLING HEIGHTS
State : MI
Zip : 48313-4371
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3175 S ROCHESTER RD
Second Line :
City : ROCHESTER HILLS
State : MI
Zip : 48307-5042
Country : US
Telephone Number : 248-844-5010
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/31/2018
Last Update Date : 08/04/2020

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Directions to “ VANNA FACHOU ” Practice Location

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