Provider Demographics
NPI:1386260982
Name:AKHUMIAN, MIRA (PHARMD)
Entity type:Individual
Prefix:DR
First Name:MIRA
Middle Name:
Last Name:AKHUMIAN
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 1:5090 TURNEY RD
Mailing Address - Street 2:
Mailing Address - City:GARFIELD HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44125-2603
Mailing Address - Country:US
Mailing Address - Phone:216-581-6791
Mailing Address - Fax:216-581-3318
Practice Address - Street 1:5090 TURNEY RD
Practice Address - Street 2:
Practice Address - City:GARFIELD HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44125-2603
Practice Address - Country:US
Practice Address - Phone:216-581-6791
Practice Address - Fax:216-581-3318
Is Sole Proprietor?:No
Enumeration Date:2020-06-19
Last Update Date:2020-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRPH.03234243-2183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist