Provider Demographics
NPI:1841588522
Name:KASIM, ODAY ALI (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:ODAY
Middle Name:ALI
Last Name:KASIM
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9375 CHERRY VALLEY AVE.
Mailing Address - Street 2:
Mailing Address - City:CALEDONIA
Mailing Address - State:MI
Mailing Address - Zip Code:49316
Mailing Address - Country:US
Mailing Address - Phone:616-891-7898
Mailing Address - Fax:616-891-8097
Practice Address - Street 1:9375 CHERRY VALLEY AVE.
Practice Address - Street 2:
Practice Address - City:CALEDONIA
Practice Address - State:MI
Practice Address - Zip Code:49316
Practice Address - Country:US
Practice Address - Phone:616-891-7898
Practice Address - Fax:616-891-8097
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-15
Last Update Date:2012-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302034751183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist