Provider Demographics
NPI:1184867228
Name:FAKHOURY, SARA ALHAN (RPH)
Entity Type:Individual
Prefix:MRS
First Name:SARA
Middle Name:ALHAN
Last Name:FAKHOURY
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2114 HAVERFORD DR
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48098-5331
Mailing Address - Country:US
Mailing Address - Phone:248-952-5879
Mailing Address - Fax:
Practice Address - Street 1:1378 WALTON BLVD
Practice Address - Street 2:
Practice Address - City:ROCHESTER HILLS
Practice Address - State:MI
Practice Address - Zip Code:48309-1754
Practice Address - Country:US
Practice Address - Phone:248-652-0900
Practice Address - Fax:248-652-2102
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-17
Last Update Date:2009-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI26115183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist