Jacob Thoppilkalathil Abraham, R.PH
Individual provider Active NPI Pharmacist · Waxhaw, NC
NPI 1336462779 · NPPES record last updated May 6, 2021
Key facts
- NPI
- 1336462779
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 16030 (NC)
- Practice address
- 8157 Kensington Dr
Waxhaw, NC 28173-0103 - Phone
- (704) 243-2034
- Fax
- (704) 243-7853
- NPI assigned
- Mar 11, 2010
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 4
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 16030 | NC | MD | Massage Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Happy Meds Limited Liability Company | Current | Accepting new patients | |
| Happy Meds Limited Liability Company | Current | Accepting new patients | |
| Harris Teeter, LLC | Past | Accepting new patients | |
| Harris Teeter LLC | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 16030 | NC | Yes |
Addresses
Primary practice location
8157 Kensington Dr
Waxhaw, NC 28173-0103
Mailing address
3300 Monroe Rd Ste Ef
Charlotte, NC 28205-7853
Phone (800) 589-5737
Other providers in Waxhaw, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 6, 2021. 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.