Active NPI
Hanna A Mekonnen, PHARMACIST
- Pharmacist
- North Las Vegas, NV
National Provider Identifier
1013631274
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 22895
- Practice address
- 4755 W Ann Rd
North Las Vegas, NV 89031-3424 - Phone
- (702) 645-1360
- Fax
- (702) 396-8514
- NPI assigned
- Sep 30, 2022
- Sex
- Female
- Sole proprietor
- Yes
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 | 22895 | NV | Primary |
Addresses
Primary practice location
4755 W Ann Rd
North Las Vegas, NV 89031-3424
Mailing address
9883 Mount Madera St
Las Vegas, NV 89178-7518
Phone (469) 867-1576
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1602642642 | Other | NV | DEIVER LICENCE NUMBER |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1664496000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1664496000000",
"number": "1013631274",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9883 MOUNT MADERA ST",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891787518",
"telephone_number": "469-867-1576"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4755 W ANN RD",
"city": "NORTH LAS VEGAS",
"state": "NV",
"postal_code": "890313424",
"telephone_number": "702-645-1360",
"fax_number": "702-396-8514"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MEKONNEN",
"first_name": "HANNA",
"middle_name": "A",
"credential": "PHARMACIST",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-09-30",
"last_updated": "2022-09-30",
"certification_date": "2022-09-30",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NV",
"license": "22895",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DEIVER LICENCE NUMBER",
"identifier": "1602642642",
"state": "NV"
}
],
"endpoints": [],
"other_names": []
}
Other providers in North Las Vegas, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.