Provider Demographics
NPI:1912950163
Name:RABINOWITZ, IRWIN (RPH)
Entity Type:Individual
Prefix:
First Name:IRWIN
Middle Name:
Last Name:RABINOWITZ
Suffix:
Gender:M
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:JUNCTION CLINIC PHARMACY 4771 MICHIGAN AVE.
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48210
Mailing Address - Country:US
Mailing Address - Phone:313-898-6946
Mailing Address - Fax:313-897-2424
Practice Address - Street 1:JUNCTION CLINIC PHARMACY 4771 MICHIGAN AVE.
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48210
Practice Address - Country:US
Practice Address - Phone:313-898-6946
Practice Address - Fax:313-897-2424
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302018933183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI2330075Medicaid
MI2330075OtherNABP #
MI2330075Medicaid