Active NPI
Amjad Azzawe
- Pharmacist
- Philadelphia, PA
National Provider Identifier
1376160374
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RP454477
- Practice address
- 1335 Mount Vernon St
Philadelphia, PA 19123-3211 - Phone
- (214) 238-9055
- NPI assigned
- Jun 25, 2020
- Last updated
- Jun 25, 2020
- 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 | RP454477 | PA | Primary |
Addresses
Primary practice location
1335 Mount Vernon St
Philadelphia, PA 19123-3211
Mailing address
127 W Salaignac St
Philadelphia, PA 19127-1820
Phone (318) 230-4105
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| RP454477 | Other | PA | PA PHARMACIST LICENSE |
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 |
|---|---|---|---|
| RP454477 | PA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1593043200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1593043200000",
"number": "1376160374",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "127 W SALAIGNAC ST",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191271820",
"telephone_number": "318-230-4105"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1335 MOUNT VERNON ST",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191233211",
"telephone_number": "214-238-9055"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AZZAWE",
"first_name": "AMJAD",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-06-25",
"last_updated": "2020-06-25",
"certification_date": "2020-06-25",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "PA",
"license": "RP454477",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PA PHARMACIST LICENSE",
"identifier": "RP454477",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 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.