Provider Demographics
NPI:1154952299
Name:DAKROUB, HANA HASSAN (PHARMD)
Entity type:Individual
Prefix:
First Name:HANA
Middle Name:HASSAN
Last Name:DAKROUB
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23001 COOLIDGE HWY
Mailing Address - Street 2:
Mailing Address - City:OAK PARK
Mailing Address - State:MI
Mailing Address - Zip Code:48237-2071
Mailing Address - Country:US
Mailing Address - Phone:248-547-8230
Mailing Address - Fax:248-547-5021
Practice Address - Street 1:23001 COOLIDGE HWY
Practice Address - Street 2:
Practice Address - City:OAK PARK
Practice Address - State:MI
Practice Address - Zip Code:48237-2071
Practice Address - Country:US
Practice Address - Phone:248-547-8230
Practice Address - Fax:248-547-5021
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-28
Last Update Date:2020-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302043454183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist