Provider Demographics
NPI:1013356062
Name:SAFAWI, HUSSEIN (RPH, MBA)
Entity Type:Individual
Prefix:
First Name:HUSSEIN
Middle Name:
Last Name:SAFAWI
Suffix:
Gender:M
Credentials:RPH, MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14825 W MCNICHOLS RD # RS
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48235-3939
Mailing Address - Country:US
Mailing Address - Phone:313-231-2559
Mailing Address - Fax:
Practice Address - Street 1:14825 W MCNICHOLS RD
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48235-3939
Practice Address - Country:US
Practice Address - Phone:313-231-2559
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-21
Last Update Date:2021-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302033033183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist