Active NPI
Mursal A Mursal, PHARMACIST
- Pharmacist
- Tuba City, AZ
National Provider Identifier
1003473398
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 0202215244
- Practice address
- 167 Main St
Tuba City, AZ 86045-1675 - Phone
- (928) 283-1432
- NPI assigned
- May 22, 2019
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 0202215244 | VA | Primary |
Addresses
Primary practice location
167 Main St
Tuba City, AZ 86045-1675
Mailing address
5012 Head CT
Fairfax, VA 22032-2509
Phone (703) 963-8439
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0202215244 | VA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1558483200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1696204800000",
"number": "1003473398",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5012 HEAD CT",
"city": "FAIRFAX",
"state": "VA",
"postal_code": "220322509",
"telephone_number": "703-963-8439"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "167 MAIN ST",
"city": "TUBA CITY",
"state": "AZ",
"postal_code": "860451675",
"telephone_number": "928-283-1432"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MURSAL",
"first_name": "MURSAL",
"middle_name": "A",
"credential": "PHARMACIST",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-05-22",
"last_updated": "2023-10-02",
"certification_date": "2023-09-29",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "VA",
"license": "0202215244",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tuba City, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.