Provider Demographics
NPI:1871247460
Name:CHEAITO, HASSAN (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:HASSAN
Middle Name:
Last Name:CHEAITO
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 1:27144 JOY RD
Mailing Address - Street 2:
Mailing Address - City:REDFORD
Mailing Address - State:MI
Mailing Address - Zip Code:48239-2368
Mailing Address - Country:US
Mailing Address - Phone:313-937-3000
Mailing Address - Fax:313-937-0300
Practice Address - Street 1:27144 JOY RD
Practice Address - Street 2:
Practice Address - City:REDFORD
Practice Address - State:MI
Practice Address - Zip Code:48239-2368
Practice Address - Country:US
Practice Address - Phone:313-937-3000
Practice Address - Fax:313-937-0300
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-11
Last Update Date:2022-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302413833183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI5302413833OtherPHARMACY LICENSE