Individual provider Active NPI

Pedram Ghafourifar, PHARMD

  • Pharmacist
  • Charleston, WV
National Provider Identifier
1144716614
Registry record updated Jul 7, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
RP0010506 Issued in WV
Practice address
1701 4TH Ave
Charleston, WV 25387-2415
Phone
(304) 346-0820
NPI assigned
Jul 7, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 7, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X RP0010506 WV Primary

Addresses

Primary practice location

1701 4TH Ave
Charleston, WV 25387-2415

Mailing address

395 Tyree Cir
Elkview, WV 25071-7680

Other identifiers 1

IdentifierTypeStateIssuer
RP0010506OtherWVWEST VIRGINIA BOARD OF PHARMACY

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
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
RP0010506WVMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1530921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530921600000",
    "number": "1144716614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "395 TYREE CIR",
            "city": "ELKVIEW",
            "state": "WV",
            "postal_code": "250717680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 4TH AVE",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253872415",
            "telephone_number": "304-346-0820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GHAFOURIFAR",
        "first_name": "PEDRAM",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-07-07",
        "last_updated": "2018-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WV",
            "license": "RP0010506",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WEST VIRGINIA BOARD OF PHARMACY",
            "identifier": "RP0010506",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.