Provider Demographics
NPI:1396335352
Name:FARHAT, MARWA (RPH)
Entity type:Individual
Prefix:
First Name:MARWA
Middle Name:
Last Name:FARHAT
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 1:3437 BENNETT ST
Mailing Address - Street 2:
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48124-3517
Mailing Address - Country:US
Mailing Address - Phone:313-335-7607
Mailing Address - Fax:
Practice Address - Street 1:3437 BENNETT ST
Practice Address - Street 2:
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48124-3517
Practice Address - Country:US
Practice Address - Phone:313-335-7607
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-24
Last Update Date:2021-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302413233183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist