Provider Demographics
NPI:1043502578
Name:MORAD, RITA (PHARMD)
Entity Type:Individual
Prefix:
First Name:RITA
Middle Name:
Last Name:MORAD
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:51207 CLEAR SPRING LN
Mailing Address - Street 2:
Mailing Address - City:SHELBY TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48316-4021
Mailing Address - Country:US
Mailing Address - Phone:248-798-3816
Mailing Address - Fax:
Practice Address - Street 1:5400 PERRY DR
Practice Address - Street 2:
Practice Address - City:WATERFORD
Practice Address - State:MI
Practice Address - Zip Code:48329-3461
Practice Address - Country:US
Practice Address - Phone:248-674-7963
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-03
Last Update Date:2011-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302037577183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist