Provider Demographics
NPI:1063164945
Name:FARHAT, LENA (PHARMACIST)
Entity type:Individual
Prefix:MS
First Name:LENA
Middle Name:
Last Name:FARHAT
Suffix:
Gender:F
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6207 COOLIDGE ST
Mailing Address - Street 2:
Mailing Address - City:DEARBORN HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48127-2878
Mailing Address - Country:US
Mailing Address - Phone:313-932-2448
Mailing Address - Fax:313-928-2225
Practice Address - Street 1:6811 ALLEN RD
Practice Address - Street 2:
Practice Address - City:ALLEN PARK
Practice Address - State:MI
Practice Address - Zip Code:48101-2007
Practice Address - Country:US
Practice Address - Phone:313-443-0948
Practice Address - Fax:313-928-2225
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-22
Last Update Date:2022-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302412846183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist