Syed Mudassir Ali, RPH
Individual provider Active NPI Pharmacist · Augusta, ME
NPI 1104130640 · NPPES record last updated Jul 26, 2010
Key facts
- NPI
- 1104130640
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- PR5512 (ME)
- Practice address
- 2007 N Belfast Ave
Rite Aid Pharmacy
Augusta, ME 04330-4363 - Phone
- (207) 622-2626
- Fax
- (207) 622-0721
- NPI assigned
- Jul 26, 2010
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PR5512 | ME | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PR5512 | ME | Yes |
Addresses
Primary practice location
2007 N Belfast Ave
Rite Aid Pharmacy
Augusta, ME 04330-4363
Mailing address
2007 N Belfast Ave
Rite Aid Pharmacy
Augusta, ME 04330-4363
Phone (207) 622-2626
Other providers in Augusta, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 26, 2010. 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.