Provider Demographics
NPI:1992553069
Name:AMEEN, WAEEL (BSC PHARM)
Entity type:Individual
Prefix:
First Name:WAEEL
Middle Name:
Last Name:AMEEN
Suffix:
Gender:M
Credentials:BSC PHARM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 E PINE ST
Mailing Address - Street 2:
Mailing Address - City:IRONWOOD
Mailing Address - State:MI
Mailing Address - Zip Code:49938-2730
Mailing Address - Country:US
Mailing Address - Phone:989-208-9611
Mailing Address - Fax:
Practice Address - Street 1:802 E CLOVERLAND DR
Practice Address - Street 2:
Practice Address - City:IRONWOOD
Practice Address - State:MI
Practice Address - Zip Code:49938-1502
Practice Address - Country:US
Practice Address - Phone:906-932-4267
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-13
Last Update Date:2024-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302415868183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist