Provider Demographics
NPI:1801902937
Name:ELHASAN, ALI RASHID (RPH)
Entity type:Individual
Prefix:MR
First Name:ALI
Middle Name:RASHID
Last Name:ELHASAN
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:18287 ALLEN RD
Mailing Address - Street 2:
Mailing Address - City:MELVINDALE
Mailing Address - State:MI
Mailing Address - Zip Code:48122-1513
Mailing Address - Country:US
Mailing Address - Phone:313-386-0830
Mailing Address - Fax:313-386-0907
Practice Address - Street 1:18287 ALLEN RD
Practice Address - Street 2:
Practice Address - City:MELVINDALE
Practice Address - State:MI
Practice Address - Zip Code:48122-1513
Practice Address - Country:US
Practice Address - Phone:313-386-0830
Practice Address - Fax:313-386-0907
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI5302028620183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist