Active NPI
Kebede Maru, PHARMACIST
- Pharmacist
- Richmond, VA
National Provider Identifier
1346825502
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 0202208198
- Practice address
- 5221 Brook Rd
Richmond, VA 23227-2901 - Phone
- (804) 266-4768
- NPI assigned
- Mar 9, 2021
- 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 | 0202208198 | VA | Primary |
Addresses
Primary practice location
5221 Brook Rd
Richmond, VA 23227-2901
Mailing address
4111 Morin St
Alexandria, VA 22312-1054
Phone (703) 956-0414
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
| License | State | Type | Specialty |
|---|---|---|---|
| 0202208198 | VA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wal-Mart Stores East, LP | Past | 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": "1615248000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1615248000000",
"number": "1346825502",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4111 MORIN ST",
"city": "ALEXANDRIA",
"state": "VA",
"postal_code": "223121054",
"telephone_number": "703-956-0414"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5221 BROOK RD",
"city": "RICHMOND",
"state": "VA",
"postal_code": "232272901",
"telephone_number": "804-266-4768"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARU",
"first_name": "KEBEDE",
"credential": "PHARMACIST",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-03-09",
"last_updated": "2021-03-09",
"certification_date": "2021-03-09",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "VA",
"license": "0202208198",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Richmond, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.