Provider Demographics
NPI:1821740036
Name:AHMED, MONA ABDUL (PHARMACY TECHNICIAN)
Entity Type:Individual
Prefix:
First Name:MONA
Middle Name:ABDUL
Last Name:AHMED
Suffix:
Gender:F
Credentials:PHARMACY TECHNICIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1504 SALINA ST
Mailing Address - Street 2:
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48120-1735
Mailing Address - Country:US
Mailing Address - Phone:313-327-9903
Mailing Address - Fax:
Practice Address - Street 1:5650 SCHAEFER RD
Practice Address - Street 2:
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48126-2253
Practice Address - Country:US
Practice Address - Phone:313-581-3280
Practice Address - Fax:313-584-9304
Is Sole Proprietor?:No
Enumeration Date:2022-01-19
Last Update Date:2022-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5303022676183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician