Active NPI
Haissam Nayef Shiblak, RPH
- Pharmacist
- Queen Creek, AZ
National Provider Identifier
1306986542
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 15345
- Practice address
- 18495 E Queen Creek Rd
Queen Creek, AZ 85242-3597 - Phone
- (480) 279-0521
- Fax
- (480) 279-5425
- NPI assigned
- Feb 7, 2007
- 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 | 15345 | AZ | Primary |
Addresses
Primary practice location
18495 E Queen Creek Rd
Queen Creek, AZ 85242-3597
Mailing address
1633 E Zion Way
Chandler, AZ 85249-2862
Phone (480) 279-0521
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
| License | State | Type | Specialty |
|---|---|---|---|
| 15345 | AZ | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170806400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1306986542",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1633 E ZION WAY",
"city": "CHANDLER",
"state": "AZ",
"postal_code": "852492862",
"telephone_number": "480-279-0521",
"fax_number": "480-279-5425"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "18495 E QUEEN CREEK RD",
"city": "QUEEN CREEK",
"state": "AZ",
"postal_code": "852423597",
"telephone_number": "480-279-0521",
"fax_number": "480-279-5425"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHIBLAK",
"first_name": "HAISSAM",
"middle_name": "NAYEF",
"name_prefix": "Mr.",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-02-07",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "AZ",
"license": "15345",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Queen Creek, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.