Provider Demographics
NPI:1891382396
Name:ESHO, BESMAH (RPH)
Entity Type:Individual
Prefix:MRS
First Name:BESMAH
Middle Name:
Last Name:ESHO
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22952 CYPRUS DR
Mailing Address - Street 2:
Mailing Address - City:NORTHVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48167-8510
Mailing Address - Country:US
Mailing Address - Phone:248-767-2495
Mailing Address - Fax:
Practice Address - Street 1:22500 W 8 MILE RD
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48033-4365
Practice Address - Country:US
Practice Address - Phone:248-357-2158
Practice Address - Fax:248-357-2176
Is Sole Proprietor?:No
Enumeration Date:2020-12-30
Last Update Date:2020-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302032183183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist