Provider Demographics
NPI:1629729066
Name:EL-ALIE, ALIE R (PHARMD)
Entity Type:Individual
Prefix:
First Name:ALIE
Middle Name:R
Last Name:EL-ALIE
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:921 BEECHMONT ST
Mailing Address - Street 2:
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48124-1512
Mailing Address - Country:US
Mailing Address - Phone:313-623-3326
Mailing Address - Fax:
Practice Address - Street 1:753 W 9 MILE RD
Practice Address - Street 2:
Practice Address - City:FERNDALE
Practice Address - State:MI
Practice Address - Zip Code:48220-1217
Practice Address - Country:US
Practice Address - Phone:248-565-8031
Practice Address - Fax:248-565-8358
Is Sole Proprietor?:No
Enumeration Date:2022-01-18
Last Update Date:2022-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302039263183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist