Provider Demographics
NPI:1093454266
Name:BARAKATE, YOUSSEF AHMAD (RPH)
Entity Type:Individual
Prefix:
First Name:YOUSSEF
Middle Name:AHMAD
Last Name:BARAKATE
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 1:101 N EUCLID AVE
Mailing Address - Street 2:
Mailing Address - City:BAY CITY
Mailing Address - State:MI
Mailing Address - Zip Code:48706-2939
Mailing Address - Country:US
Mailing Address - Phone:989-686-2807
Mailing Address - Fax:
Practice Address - Street 1:101 N EUCLID AVE
Practice Address - Street 2:
Practice Address - City:BAY CITY
Practice Address - State:MI
Practice Address - Zip Code:48706-2939
Practice Address - Country:US
Practice Address - Phone:989-686-2807
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-03
Last Update Date:2022-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302039802183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist