Provider Demographics
NPI:1851064596
Name:TUPA, MARINELA (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:MARINELA
Middle Name:
Last Name:TUPA
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:43653 WESTMINISTER WAY
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:MI
Mailing Address - Zip Code:48187-3158
Mailing Address - Country:US
Mailing Address - Phone:734-623-3011
Mailing Address - Fax:
Practice Address - Street 1:24615 HALSTED RD
Practice Address - Street 2:
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48335-1611
Practice Address - Country:US
Practice Address - Phone:248-957-6100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-28
Last Update Date:2021-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302412754183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist