MEDICARE: AHMAD ALI HARB

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	5302414048	MI

General Provider Information

NPI Number	:	1952058661
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AHMAD ALI HARB

Provider Business Mailing Address
First Line	:	25428 ELON DR
Second Line	:
City	:	DEARBORN HEIGHTS
State	:	MI
Zip	:	48127-3805
Country	:	US
Telephone Number	:	313-549-5009
Fax Number	:

Provider Business Practice Location Address
First Line	:	100 W GRAND RIVER AVE
Second Line	:
City	:	EAST LANSING
State	:	MI
Zip	:	48823-4325
Country	:	US
Telephone Number	:	517-318-0304
Fax Number	:	517-318-0305

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

Provider Enumeration Date	:	03/03/2022
Last Update Date	:	03/03/2022

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