Provider Demographics
NPI:1437432200
Name:HINNAWI, ALICE
Entity Type:Individual
Prefix:MRS
First Name:ALICE
Middle Name:
Last Name:HINNAWI
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 1:8706 N TELEGRAPH RD
Mailing Address - Street 2:
Mailing Address - City:DEARBORN HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48127-1457
Mailing Address - Country:US
Mailing Address - Phone:313-724-9078
Mailing Address - Fax:313-724-9064
Practice Address - Street 1:8706 N TELEGRAPH RD
Practice Address - Street 2:
Practice Address - City:DEARBORN HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48127-1457
Practice Address - Country:US
Practice Address - Phone:313-724-9078
Practice Address - Fax:313-724-9064
Is Sole Proprietor?:No
Enumeration Date:2011-09-27
Last Update Date:2011-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302028269183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist