Active NPI
Raafat George Gerges, PHARMACIST
- Pharmacist
- Moreno Valley, CA
National Provider Identifier
1225334717
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 45091
- Practice address
- 12730 Heacock St
Suite 1
Moreno Valley, CA 92553-3040 - Phone
- (951) 485-1234
- Fax
- (951) 485-3233
- NPI assigned
- Feb 1, 2011
- Last updated
- Feb 1, 2011
- Sex
- Male
- Sole proprietor
- Yes
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 | 45091 | CA | Primary |
Addresses
Primary practice location
12730 Heacock St
Suite 1
Moreno Valley, CA 92553-3040
Mailing address
12730 Heacock St
Suite 1
Moreno Valley, CA 92553-3040
Phone (951) 485-1234
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PHA473390 | Medicaid | CA |
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
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Daniel's Pharmacy
- Community/Retail Pharmacy
- Moreno Valley, CA
- NPI 1932142718
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1296518400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1296518400000",
"number": "1225334717",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12730 HEACOCK ST",
"address_2": "SUITE 1",
"city": "MORENO VALLEY",
"state": "CA",
"postal_code": "925533040",
"telephone_number": "951-485-1234",
"fax_number": "951-485-3233"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12730 HEACOCK ST",
"address_2": "SUITE 1",
"city": "MORENO VALLEY",
"state": "CA",
"postal_code": "925533040",
"telephone_number": "951-485-1234",
"fax_number": "951-485-3233"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GERGES",
"first_name": "RAAFAT",
"middle_name": "GEORGE",
"credential": "PHARMACIST",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-02-01",
"last_updated": "2011-02-01",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "45091",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "PHA473390",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Moreno Valley, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.