Individual provider Active NPI

Wagma Komak, PHARMD

  • Pharmacist
  • Tucson, AZ
National Provider Identifier
1033493085
Registry record updated Oct 7, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
S016372 Issued in AZ
Practice address
3675 E Britannia Dr
Tucson, AZ 85706-5041
Phone
(520) 209-3000
NPI assigned
Oct 7, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X S016372 AZ Primary

Addresses

Primary practice location

3675 E Britannia Dr
Tucson, AZ 85706-5041

Mailing address

8021 N Coltrane LN
Tucson, AZ 85743-7327
Phone (520) 991-1466

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
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
S016372AZMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Department of Veterans Affairs Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1317945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317945600000",
    "number": "1033493085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8021 N COLTRANE LN",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857437327",
            "telephone_number": "520-991-1466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3675 E BRITANNIA DR",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857065041",
            "telephone_number": "520-209-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOMAK",
        "first_name": "WAGMA",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-07",
        "last_updated": "2011-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "AZ",
            "license": "S016372",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.