Individual provider Active NPI

Imene Amor, PHARMD

  • Pharmacist
  • Belleville, IL
National Provider Identifier
1255098760
Registry record updated Nov 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
2021015001 Issued in MO
Practice address
1 Royal Heights Ctr
Belleville, IL 62226-5705
Phone
(618) 233-0100
NPI assigned
Nov 18, 2021
Last updated
Nov 18, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 18, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 2021015001 MO Primary

Addresses

Primary practice location

1 Royal Heights Ctr
Belleville, IL 62226-5705

Mailing address

1328 Forrest Lane CT
Ballwin, MO 63011-4277
Phone (314) 817-8103

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
2021015001MOMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Avalcare CurrentSince Nov 21, 2021 Accepting new patients
Tria Pharmacy LLC Current Accepting new patients
Express Medical Pharmacy LLC PastSince Nov 21, 2021 Accepting new patients

Locations

1 Royal Heights Ctr
Belleville, IL 62226
Phone (618) 233-0100

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1637193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637193600000",
    "number": "1255098760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1328 FORREST LANE CT",
            "city": "BALLWIN",
            "state": "MO",
            "postal_code": "630114277",
            "telephone_number": "314-817-8103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 ROYAL HEIGHTS CTR",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622265705",
            "telephone_number": "618-233-0100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMOR",
        "first_name": "IMENE",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-11-18",
        "last_updated": "2021-11-18",
        "certification_date": "2021-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MO",
            "license": "2021015001",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Belleville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2021; 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.