Active NPI
Ebram Botros, RPH
- Pharmacist
- Whitehall, OH
National Provider Identifier
1063016350
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 03333872
- Practice address
- 4548 E Main St
Whitehall, OH 43213-3039 - Phone
- (614) 235-7076
- NPI assigned
- Nov 26, 2020
- Last updated
- Nov 26, 2020
- 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 | 03333872 | OH | Primary |
Addresses
Primary practice location
4548 E Main St
Whitehall, OH 43213-3039
Mailing address
1054 Brookside CT
Galena, OH 43021-2500
Phone (614) 556-2005
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
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 03333872 | OH | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ohio CVS Stores, L.L.C. | Past | Accepting new patients | |
| Ohio CVS Stores LLC | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1606348800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1606348800000",
"number": "1063016350",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1054 BROOKSIDE CT",
"city": "GALENA",
"state": "OH",
"postal_code": "430212500",
"telephone_number": "614-556-2005"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4548 E MAIN ST",
"city": "WHITEHALL",
"state": "OH",
"postal_code": "432133039",
"telephone_number": "614-235-7076"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOTROS",
"first_name": "EBRAM",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-11-26",
"last_updated": "2020-11-26",
"certification_date": "2020-11-26",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "OH",
"license": "03333872",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Whitehall, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.