Individual provider Active NPI

Mandana Mahkameh Eimen, PHARM.D

  • Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
  • Laurel, MD
National Provider Identifier
1295035319
Registry record updated Oct 22, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistTaxonomy code 1835P0018X
License
PHA3166 Issued in DC
Practice address
316 Talbott Ave Ste a
Laurel, MD 20707-4334
Phone
(301) 617-0555
NPI assigned
Oct 22, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 22, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X PHA3166 DC Primary

Addresses

Primary practice location

316 Talbott Ave Ste a
Laurel, MD 20707-4334

Mailing address

316 Talbott Ave Ste a
Laurel, MD 20707-4334
Phone (301) 617-0555

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
PHA3166DCMDPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Clinical Pharmacy Associates, Inc Pharmacist Clinician (PHC)/ Clinical Pharmacy Specialist 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": "1287705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1287705600000",
    "number": "1295035319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "316 TALBOTT AVE STE A",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207074334",
            "telephone_number": "301-617-0555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "316 TALBOTT AVE STE A",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207074334",
            "telephone_number": "301-617-0555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EIMEN",
        "first_name": "MANDANA",
        "middle_name": "MAHKAMEH",
        "credential": "PHARM.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-10-22",
        "last_updated": "2010-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "DC",
            "license": "PHA3166",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Laurel, MD

Sources for this page

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