Provider Demographics
NPI:1376208124
Name:KHOURY, ASHLEY FOUD
Entity Type:Individual
Prefix:MRS
First Name:ASHLEY
Middle Name:FOUD
Last Name:KHOURY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26395 MEADOW CREEK LN
Mailing Address - Street 2:
Mailing Address - City:WILDOMAR
Mailing Address - State:CA
Mailing Address - Zip Code:92595-4915
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:14305 MERIDIAN PKWY
Practice Address - Street 2:
Practice Address - City:MARCH AIR RESERVE BASE
Practice Address - State:CA
Practice Address - Zip Code:92518-3034
Practice Address - Country:US
Practice Address - Phone:951-313-1075
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-06
Last Update Date:2022-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA85586183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist