Individual provider Active NPI

Abdirizak Ali Mire, PHARMD

  • Pharmacist
  • Minneapolis, MN
National Provider Identifier
1164745360
Registry record updated Mar 3, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
119907 Issued in MN
Practice address
1515 E Franklin Ave
Minneapolis, MN 55404-2137
Phone
(612) 874-0575
NPI assigned
Mar 3, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 119907 MN Primary

Addresses

Primary practice location

1515 E Franklin Ave
Minneapolis, MN 55404-2137

Mailing address

1515 E Franklin Ave
Minneapolis, MN 55404-2137
Phone (612) 874-0575

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
119907MNMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Moka Pharmacy Inc 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.

NPI Registry JSON

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

{
    "created_epoch": "1267574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1267574400000",
    "number": "1164745360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1515 E FRANKLIN AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554042137",
            "telephone_number": "612-874-0575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 E FRANKLIN AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554042137",
            "telephone_number": "612-874-0575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIRE",
        "first_name": "ABDIRIZAK",
        "middle_name": "ALI",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-03-03",
        "last_updated": "2010-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MN",
            "license": "119907",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2010; 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.