Provider Demographics
NPI:1861262636
Name:HAMMOUD, MOHAMED JAY (PHARMD)
Entity type:Individual
Prefix:DR
First Name:MOHAMED
Middle Name:JAY
Last Name:HAMMOUD
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:61 W PEARL ST
Mailing Address - Street 2:
Mailing Address - City:COLDWATER
Mailing Address - State:MI
Mailing Address - Zip Code:49036-1933
Mailing Address - Country:US
Mailing Address - Phone:517-278-6186
Mailing Address - Fax:
Practice Address - Street 1:61 W PEARL ST
Practice Address - Street 2:
Practice Address - City:COLDWATER
Practice Address - State:MI
Practice Address - Zip Code:49036-1933
Practice Address - Country:US
Practice Address - Phone:517-278-6186
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-03
Last Update Date:2024-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302415692183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist