Provider Demographics
NPI:1669840013
Name:SAMAHA, HEND (RPH)
Entity Type:Individual
Prefix:MRS
First Name:HEND
Middle Name:
Last Name:SAMAHA
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 1:5100 CENTURY AVE
Mailing Address - Street 2:
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49006-5714
Mailing Address - Country:US
Mailing Address - Phone:269-743-2308
Mailing Address - Fax:
Practice Address - Street 1:5100 CENTURY AVE
Practice Address - Street 2:
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49006-5714
Practice Address - Country:US
Practice Address - Phone:269-743-2308
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-02
Last Update Date:2015-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302037227183500000X
IL051.294103183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist