NPIMap

Organization Active NPI

Pharmacy of America VI Inc.

  • Community/Retail Pharmacy
  • Philadelphia, PA
National Provider Identifier
1063815967
Registry record updated May 2, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
RP438595 Issued in PA
Legal business name
PHARMACY OF AMERICA VI INC.
Practice address
919 Levick St
Philadelphia, PA 19111-5421
Phone
(267) 237-1188
Fax
(215) 744-0333
NPI assigned
Oct 6, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 2, 2019

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

Authorized official

Name
Dr. Sabri Zaidan Ibrahim, PHARM D.
Title
President & Ceo
Phone
(267) 237-1188

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X RP438595 PA Primary

Addresses

Primary practice location

919 Levick St
Philadelphia, PA 19111-5421

Mailing address

4654 N 5TH St
Philadelphia, PA 19140-1420
Phone (267) 237-1188

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240625003604 PA Part B Supplier - Pharmacy 4284178773 Practice locations: Philadelphia, PA

National Provider Directory

National Provider Directory

Locations

919 Levick St
Philadelphia, PA 19111
Phone (215) 535-0555

NPI Registry JSON

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

{
    "created_epoch": "1412553600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1556755200000",
    "number": "1063815967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4654 N 5TH ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191401420",
            "telephone_number": "267-237-1188",
            "fax_number": "215-744-0333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "919 LEVICK ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191115421",
            "telephone_number": "267-237-1188",
            "fax_number": "215-744-0333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHARMACY OF AMERICA VI INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-06",
        "last_updated": "2019-05-02",
        "status": "A",
        "authorized_official_last_name": "IBRAHIM",
        "authorized_official_first_name": "SABRI",
        "authorized_official_middle_name": "ZAIDAN",
        "authorized_official_title_or_position": "PRESIDENT & CEO",
        "authorized_official_telephone_number": "267-237-1188",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHARM D."
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "PA",
            "license": "RP438595",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.