Provider Demographics
NPI:1780297689
Name:AL-JORANI, RAGHAD
Entity type:Individual
Prefix:
First Name:RAGHAD
Middle Name:
Last Name:AL-JORANI
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 1:29684 KENLOCH DR
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48331-1916
Mailing Address - Country:US
Mailing Address - Phone:248-910-0688
Mailing Address - Fax:
Practice Address - Street 1:27401 6 MILE RD
Practice Address - Street 2:
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48152-3834
Practice Address - Country:US
Practice Address - Phone:734-762-0627
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-28
Last Update Date:2020-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302412899183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist