Provider Demographics
NPI:1083205140
Name:HAILEMICHAEL, ALEM BELACHEW (PHARM D)
Entity type:Individual
Prefix:
First Name:ALEM
Middle Name:BELACHEW
Last Name:HAILEMICHAEL
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6851 ROSWELL RD APT N15
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30328-2441
Mailing Address - Country:US
Mailing Address - Phone:404-593-7270
Mailing Address - Fax:
Practice Address - Street 1:6851 ROSWELL RD APT N15
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30328-2441
Practice Address - Country:US
Practice Address - Phone:404-593-7270
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-01
Last Update Date:2021-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH026402333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy