Provider Demographics
NPI:1356682538
Name:KOUSA, LUBNA E (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:LUBNA
Middle Name:E
Last Name:KOUSA
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 1:777 S EDEN ST
Mailing Address - Street 2:APT #501
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21231-3362
Mailing Address - Country:US
Mailing Address - Phone:216-926-4311
Mailing Address - Fax:
Practice Address - Street 1:5901 HOLABIRD AVE
Practice Address - Street 2:SUITE A
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21224-6015
Practice Address - Country:US
Practice Address - Phone:443-613-7570
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-03-12
Last Update Date:2013-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDMD208011835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist