Provider Demographics
NPI:1063510923
Name:HAMMOUD, HOUSSEIN (RPH)
Entity Type:Individual
Prefix:MR
First Name:HOUSSEIN
Middle Name:
Last Name:HAMMOUD
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2610 ST.CLAIR
Mailing Address - Street 2:
Mailing Address - City:WINDSOR
Mailing Address - State:ONTARIO
Mailing Address - Zip Code:N9E 4L6
Mailing Address - Country:CA
Mailing Address - Phone:519-919-1234
Mailing Address - Fax:
Practice Address - Street 1:1684 FORT ST
Practice Address - Street 2:
Practice Address - City:LINCOLN PARK
Practice Address - State:MI
Practice Address - Zip Code:48146
Practice Address - Country:US
Practice Address - Phone:313-383-5700
Practice Address - Fax:313-383-7866
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302031631183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist