Active NPI
Pharmacy of America IV Inc.
- Pharmacy
- Philadelphia, PA
National Provider Identifier
1215370291
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacy
- Legal business name
- PHARMACY OF AMERICA IV INC.
- Practice address
- 1900 N 9TH St
Philadelphia, PA 19122 - Phone
- (267) 237-1188
- Fax
- (215) 744-0333
- NPI assigned
- Apr 9, 2013
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Sabri Ibrahim, PHARM D.
- Title
- President & Ceo
- Phone
- (267) 237-1188
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | Primary |
Addresses
Primary practice location
1900 N 9TH St
Philadelphia, PA 19122
Mailing address
4654 N 5TH St
Philadelphia, PA 19140-1420
Phone (267) 237-1188
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20240705001384 | PA | Part B Supplier - Pharmacy | 0840734521 | Practice locations: Philadelphia, PA |
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1365465600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1556841600000",
"number": "1215370291",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4654 N 5TH ST",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191401420",
"telephone_number": "267-237-1188",
"fax_number": "215-744-0333"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1900 N 9TH ST",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "19122",
"telephone_number": "267-237-1188",
"fax_number": "215-744-0333"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PHARMACY OF AMERICA IV INC.",
"organizational_subpart": "NO",
"enumeration_date": "2013-04-09",
"last_updated": "2019-05-03",
"status": "A",
"authorized_official_last_name": "IBRAHIM",
"authorized_official_first_name": "SABRI",
"authorized_official_title_or_position": "PRESIDENT & CEO",
"authorized_official_telephone_number": "267-237-1188",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "PHARM D."
},
"taxonomies": [
{
"code": "333600000X",
"taxonomy_group": "",
"desc": "Pharmacy",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.