Provider Demographics
NPI:1336790799
Name:KHOULANI, HALA (RPH)
Entity Type:Individual
Prefix:
First Name:HALA
Middle Name:
Last Name:KHOULANI
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 1:1260 S LINDEN RD
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48532-3407
Mailing Address - Country:US
Mailing Address - Phone:810-820-9855
Mailing Address - Fax:810-720-3899
Practice Address - Street 1:1260 S LINDEN RD
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48532-3407
Practice Address - Country:US
Practice Address - Phone:810-820-9855
Practice Address - Fax:810-720-3899
Is Sole Proprietor?:No
Enumeration Date:2019-09-26
Last Update Date:2019-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5301010507183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist