Provider Demographics
NPI:1437781317
Name:HIJAZI, RIMA (RPH)
Entity Type:Individual
Prefix:
First Name:RIMA
Middle Name:
Last Name:HIJAZI
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 1:131 ELM ST
Mailing Address - Street 2:
Mailing Address - City:WYANDOTTE
Mailing Address - State:MI
Mailing Address - Zip Code:48192-5920
Mailing Address - Country:US
Mailing Address - Phone:734-283-7007
Mailing Address - Fax:
Practice Address - Street 1:131 ELM ST
Practice Address - Street 2:
Practice Address - City:WYANDOTTE
Practice Address - State:MI
Practice Address - Zip Code:48192-5920
Practice Address - Country:US
Practice Address - Phone:734-283-7007
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-07
Last Update Date:2020-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5315120692183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist