Provider Demographics
NPI:1578559712
Name:RUKIEH, NUHA S (RPH)
Entity Type:Individual
Prefix:
First Name:NUHA
Middle Name:S
Last Name:RUKIEH
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 1:1461 OAKCREST DR
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48083-5335
Mailing Address - Country:US
Mailing Address - Phone:248-689-2460
Mailing Address - Fax:
Practice Address - Street 1:29101 JOHN R RD
Practice Address - Street 2:
Practice Address - City:MADISON HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48071-5403
Practice Address - Country:US
Practice Address - Phone:248-546-8076
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302026850183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist