Individual provider Active NPI

Malek Mediouni, PHARMD

  • Pharmacist
  • Scarborough, ME
National Provider Identifier
1376144253
Registry record updated Dec 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PR6024 Issued in ME
Practice address
145 Pleasant Hill Rd
Scarborough, ME 04074-9309
Phone
(207) 885-3040
NPI assigned
Nov 5, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PR6024 ME Primary

Addresses

Primary practice location

145 Pleasant Hill Rd
Scarborough, ME 04074-9309

Mailing address

145 Pleasant Hill Rd
Scarborough, ME 04074-9309
Phone (207) 885-3040

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
PR6024MEMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1604534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606953600000",
    "number": "1376144253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "145 PLEASANT HILL RD",
            "city": "SCARBOROUGH",
            "state": "ME",
            "postal_code": "040749309",
            "telephone_number": "207-885-3040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "145 PLEASANT HILL RD",
            "city": "SCARBOROUGH",
            "state": "ME",
            "postal_code": "040749309",
            "telephone_number": "207-885-3040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDIOUNI",
        "first_name": "MALEK",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-11-05",
        "last_updated": "2020-12-03",
        "certification_date": "2020-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "ME",
            "license": "PR6024",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scarborough, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2020; 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.