Mohamed Aboubadria
Individual provider Active NPI Pharmacist · Coon Rapids, MN
NPI 1083339766 · NPPES record last updated Oct 5, 2022
Key facts
- NPI
- 1083339766
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 123579 (MN)
- Practice address
- 8600 Springbrook Dr NW
Coon Rapids, MN 55433-6033 - Phone
- (763) 785-0720
- NPI assigned
- Oct 5, 2022
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 123579 | MN | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 123579 | MN | Yes |
Addresses
Primary practice location
8600 Springbrook Dr NW
Coon Rapids, MN 55433-6033
Mailing address
10037 Toledo Dr N
Brooklyn Park, MN 55443-2378
Phone (952) 219-2546
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 123579 | Other | MINNESOTA BOARD OF PHARMACY |
Other providers in Coon Rapids, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 5, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.