Active NPI
Manhal Saif Beba
- Pharmacist
- Birmingham, MI
National Provider Identifier
1295519122
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 5302415497
- Practice address
- 444 S Old Woodward Ave
Birmingham, MI 48009-6610 - Phone
- (248) 647-0790
- NPI assigned
- Aug 22, 2023
- Last updated
- Aug 22, 2023
- Sex
- Male
- Sole proprietor
- No
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 | 5302415497 | MI | Primary |
Addresses
Primary practice location
444 S Old Woodward Ave
Birmingham, MI 48009-6610
Mailing address
55490 Apple LN
Shelby Township, MI 48316-5334
Phone (586) 382-3611
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5302415497 | MI | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Woodward Detroit CVS, L.L.C. | 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, 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": "1692662400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1692662400000",
"number": "1295519122",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "55490 APPLE LN",
"city": "SHELBY TOWNSHIP",
"state": "MI",
"postal_code": "483165334",
"telephone_number": "586-382-3611"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "444 S OLD WOODWARD AVE",
"city": "BIRMINGHAM",
"state": "MI",
"postal_code": "480096610",
"telephone_number": "248-647-0790"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BEBA",
"first_name": "MANHAL",
"middle_name": "SAIF",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-08-22",
"last_updated": "2023-08-22",
"certification_date": "2023-08-22",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MI",
"license": "5302415497",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Birmingham, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.