Individual provider Active NPI

Elias Dahham, RPH

  • Pharmacist
  • Jacksonville, FL
National Provider Identifier
1245683465
Registry record updated Jul 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PS 54791 Issued in FL
Practice address
11001 Old Saint Augustine Rd Apt 1423
Jacksonville, FL 32257-1194
Phone
(904) 930-8550
NPI assigned
Jul 22, 2016
Last updated
Jul 22, 2016By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 22, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PS 54791 FL Primary

Addresses

Primary practice location

11001 Old Saint Augustine Rd Apt 1423
Jacksonville, FL 32257-1194

Mailing address

11001 Old Saint Augustine Rd Apt 1423
Jacksonville, FL 32257-1194
Phone (904) 930-8550

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
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
PS 54791FLMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1469145600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1469145600000",
    "number": "1245683465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11001 OLD SAINT AUGUSTINE RD APT 1423",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322571194",
            "telephone_number": "904-930-8550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11001 OLD SAINT AUGUSTINE RD APT 1423",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322571194",
            "telephone_number": "904-930-8550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAHHAM",
        "first_name": "ELIAS",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-07-22",
        "last_updated": "2016-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS 54791",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2016; 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.