Active NPI
Fariborz Boroumand
- Pharmacist
- Peoria, AZ
National Provider Identifier
1356764575
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- S013652
- Practice address
- 7975 W Peoria Ave
Peoria, AZ 85345-5941 - Phone
- (623) 878-4307
- NPI assigned
- Jan 23, 2014
- Last updated
- Jan 23, 2014
- Sex
- Male
- Sole proprietor
- Yes
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 | S013652 | AZ | Primary |
Addresses
Primary practice location
7975 W Peoria Ave
Peoria, AZ 85345-5941
Mailing address
7427 W Sanna St
Peoria, AZ 85345-7195
Phone (520) 744-3531
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| S013652 | Other | AZ | ARIZONA STATE BOARD PHARMACY |
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 |
|---|---|---|---|
| S013652 | AZ | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walmart Inc. | Past | Accepting new patients | |
| Walmart Inc. | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1390435200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1390435200000",
"number": "1356764575",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7427 W SANNA ST",
"city": "PEORIA",
"state": "AZ",
"postal_code": "853457195",
"telephone_number": "520-744-3531"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7975 W PEORIA AVE",
"city": "PEORIA",
"state": "AZ",
"postal_code": "853455941",
"telephone_number": "623-878-4307"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOROUMAND",
"first_name": "FARIBORZ",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-01-23",
"last_updated": "2014-01-23",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "AZ",
"license": "S013652",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ARIZONA STATE BOARD PHARMACY",
"identifier": "S013652",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Peoria, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.