Active NPI
Martin Amoako Antoh
- Pharmacist
- Camden, DE
National Provider Identifier
1124629670
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- A1-003407
- Practice address
- 263 Walmart Dr
Camden, DE 19934-1308 - Phone
- (302) 698-1767
- Fax
- (302) 698-9032
- NPI assigned
- Nov 2, 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 | A1-003407 | DE | Primary |
Addresses
Primary practice location
263 Walmart Dr
Camden, DE 19934-1308
Mailing address
263 Walmart Dr
Camden, DE 19934-1308
Phone (302) 698-1767
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 |
|---|---|---|---|
| A1-003407 | DE | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wal-Mart Stores East, LP | Past | Accepting new patients |
Organizations & group practices 1
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.
-
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- Apollo Beach, FL
- NPI 1437027208
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1604275200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1604275200000",
"number": "1124629670",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "263 WALMART DR",
"city": "CAMDEN",
"state": "DE",
"postal_code": "199341308",
"telephone_number": "302-698-1767",
"fax_number": "302-698-1767"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "263 WALMART DR",
"city": "CAMDEN",
"state": "DE",
"postal_code": "199341308",
"telephone_number": "302-698-1767",
"fax_number": "302-698-9032"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANTOH",
"first_name": "MARTIN",
"middle_name": "AMOAKO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-11-02",
"last_updated": "2020-11-02",
"certification_date": "2020-11-02",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "DE",
"license": "A1-003407",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Camden, DE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 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.