Mosab Shalby
Individual provider Active NPI Pharmacist · Lake Charles, LA
NPI 1326697251 · NPPES record last updated Sep 4, 2019
Key facts
- NPI
- 1326697251
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- PST023202 (LA)
- Practice address
- 4097 Ryan St
Lake Charles, LA 70605-2819 - Phone
- (337) 292-6610
- NPI assigned
- Sep 4, 2019
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PST023202 | LA | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PST023202 | LA | Yes |
Addresses
Primary practice location
4097 Ryan St
Lake Charles, LA 70605-2819
Mailing address
4097 Ryan St
Lake Charles, LA 70605-2819
Other providers in Lake Charles, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 4, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.