Provider Demographics
NPI:1669848883
Name:ELTOKHY, MOHAMED (RPH)
Entity Type:Individual
Prefix:
First Name:MOHAMED
Middle Name:
Last Name:ELTOKHY
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 1:24778 W WOODSIDE CT
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48335-2133
Mailing Address - Country:US
Mailing Address - Phone:610-504-3883
Mailing Address - Fax:
Practice Address - Street 1:24778 W WOODSIDE CT
Practice Address - Street 2:
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48335-2133
Practice Address - Country:US
Practice Address - Phone:610-504-3883
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-12
Last Update Date:2015-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302037582183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist