Individual provider Active NPI

Halefom Gebremicheal Gebreyesus

  • Pharmacist
  • Philadelphia, PA
National Provider Identifier
1316728280
Registry record updated Oct 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
RP458075 Issued in PA
Practice address
6201 Germantown Ave
Philadelphia, PA 19144-2033
Phone
(215) 713-2695
NPI assigned
Oct 9, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X RP458075 PA Primary

Addresses

Primary practice location

6201 Germantown Ave
Philadelphia, PA 19144-2033

Mailing address

1310 S Harmony St
Philadelphia, PA 19146-3212
Phone (215) 789-0778

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

LicenseStateTypeSpecialty
RP458075PAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1696809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696809600000",
    "number": "1316728280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1310 S HARMONY ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191463212",
            "telephone_number": "215-789-0778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6201 GERMANTOWN AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191442033",
            "telephone_number": "215-713-2695"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GEBREYESUS",
        "first_name": "HALEFOM",
        "middle_name": "GEBREMICHEAL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-10-09",
        "last_updated": "2023-10-09",
        "certification_date": "2023-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "PA",
            "license": "RP458075",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 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.

Verify at the official NPI Registry.