Individual provider Active NPI

Mahmoud Ghanem, PHARMD.

  • Pharmacist
  • Berea, OH
National Provider Identifier
1336818756
Registry record updated Oct 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
03441157 Issued in OH
Practice address
212 W Bagley Rd
Berea, OH 44017-1830
Phone
(440) 243-6676
NPI assigned
Sep 9, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 03441157 OH Primary

Addresses

Primary practice location

212 W Bagley Rd
Berea, OH 44017-1830

Mailing address

212 W Bagley Rd
Berea, OH 44017-1830

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
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
03441157OHMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Rite Aid of Ohio Inc PastSince Sep 1, 2021 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1631145600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728777600000",
    "number": "1336818756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "212 W BAGLEY RD",
            "city": "BEREA",
            "state": "OH",
            "postal_code": "440171830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "212 W BAGLEY RD",
            "city": "BEREA",
            "state": "OH",
            "postal_code": "440171830",
            "telephone_number": "440-243-6676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GHANEM",
        "first_name": "MAHMOUD",
        "name_prefix": "Dr.",
        "credential": "PHARMD.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-09-09",
        "last_updated": "2024-10-13",
        "certification_date": "2024-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "OH",
            "license": "03441157",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Berea, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2024; 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.