Active NPI
Tayseer Azzubaydi
- Pharmacist
- Glen Allen, VA
National Provider Identifier
1063236040
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 0202222446
- Practice address
- 10901 W Broad St
Glen Allen, VA 23060-5935 - Phone
- (804) 935-6916
- NPI assigned
- Nov 14, 2024
- Sex
- Female
- 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 | 0202222446 | VA | Primary |
Addresses
Primary practice location
10901 W Broad St
Glen Allen, VA 23060-5935
Mailing address
10901 W Broad St
Glen Allen, VA 23060-5935
Phone (804) 935-6916
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 |
|---|---|---|---|
| 0202222446 | VA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Virginia CVS Pharmacy LLC | Past | Accepting new patients | |
| Virginia CVS Pharmacy, L.L.C. | 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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1731542400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1731542400000",
"number": "1063236040",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10901 W BROAD ST",
"city": "GLEN ALLEN",
"state": "VA",
"postal_code": "230605935",
"telephone_number": "804-935-6916"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10901 W BROAD ST",
"city": "GLEN ALLEN",
"state": "VA",
"postal_code": "230605935",
"telephone_number": "804-935-6916"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AZZUBAYDI",
"first_name": "TAYSEER",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-11-14",
"last_updated": "2024-11-14",
"certification_date": "2024-11-14",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "VA",
"license": "0202222446",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Glen Allen, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.