Individual provider · NPI-1
Justin Hafedh Kakos
Pharmacy Technician · Livonia, MI
NPI number1487325148
StatusActive
Last updated in NPPESSep 22, 2021
Details
- NPI
- 1487325148
- Entity type
- Individual (NPI-1)
- Name
- Justin Hafedh Kakos
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Sep 22, 2021
- Certification date
- Sep 22, 2021
- Last updated
- Sep 22, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 183700000X | Pharmacy Technician | 5303010794 | MI | Yes |
Practice location
37399 6 Mile RdLivonia, MI 48152-2775
Phone 734-464-7960
Mailing address
37399 6 Mile RdLivonia, MI 48152-2775
Phone 734-464-7960
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