Provider Demographics
NPI:1487821310
Name:HAMOOD, ALLIE (RPH)
Entity Type:Individual
Prefix:MR
First Name:ALLIE
Middle Name:
Last Name:HAMOOD
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20330 AUDETTE ST
Mailing Address - Street 2:
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48124-3969
Mailing Address - Country:US
Mailing Address - Phone:313-563-0383
Mailing Address - Fax:
Practice Address - Street 1:2305 MONROE ST
Practice Address - Street 2:
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48124-3009
Practice Address - Country:US
Practice Address - Phone:313-274-9141
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-09
Last Update Date:2008-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302411288183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist