Provider Demographics
NPI:1184034068
Name:ASHFORD, YVETTE
Entity type:Individual
Prefix:
First Name:YVETTE
Middle Name:
Last Name:ASHFORD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18839 BRETTON DR
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48223-1336
Mailing Address - Country:US
Mailing Address - Phone:313-510-1678
Mailing Address - Fax:
Practice Address - Street 1:3565 FAIRLANE DR
Practice Address - Street 2:MEIJER PHARMACY
Practice Address - City:ALLEN PARK
Practice Address - State:MI
Practice Address - Zip Code:48101-2876
Practice Address - Country:US
Practice Address - Phone:313-253-1130
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-01
Last Update Date:2014-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI53020242271835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy