Provider Demographics
NPI:1083493878
Name:THOMAS, ALEENA CHEERAMVELIL (RPH, PHARMD)
Entity Type:Individual
Prefix:
First Name:ALEENA
Middle Name:CHEERAMVELIL
Last Name:THOMAS
Suffix:
Gender:F
Credentials:RPH, PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15246 TAYLOR BLVD
Mailing Address - Street 2:
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48154-3994
Mailing Address - Country:US
Mailing Address - Phone:734-589-3886
Mailing Address - Fax:
Practice Address - Street 1:15246 TAYLOR BLVD
Practice Address - Street 2:
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48154-3994
Practice Address - Country:US
Practice Address - Phone:734-589-3886
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-21
Last Update Date:2023-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302415502183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist