Provider Demographics
NPI:1609423565
Name:QUAIL, SAMANTHA FAITH (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:SAMANTHA
Middle Name:FAITH
Last Name:QUAIL
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33510 SCHOOLCRAFT RD
Mailing Address - Street 2:
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48150-1504
Mailing Address - Country:US
Mailing Address - Phone:734-422-3310
Mailing Address - Fax:
Practice Address - Street 1:1815 ROCHESTER RD
Practice Address - Street 2:
Practice Address - City:ROYAL OAK
Practice Address - State:MI
Practice Address - Zip Code:48073-4136
Practice Address - Country:US
Practice Address - Phone:248-546-6572
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-24
Last Update Date:2020-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302411992183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist