Ronza Moutas Jamil Alamamreh
Individual provider Active NPI Pharmacist · Greenbrae, CA
NPI 1386259679 · NPPES record last updated Sep 13, 2020
Key facts
- NPI
- 1386259679
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 82798 (CA)
- Practice address
- 330 Bon Air Ctr
Greenbrae, CA 94904-3017 - Phone
- (415) 461-9093
- NPI assigned
- Sep 13, 2020
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 82798 | CA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Longs Drug Store California LLC | Past |
Accepting new patients | |
| Longs Drug Stores California LLC | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist |
183500000X | 82798 | CA | Yes |
Addresses
Primary practice location
330 Bon Air Ctr
Greenbrae, CA 94904-3017
Mailing address
330 Bon Air Ctr
Greenbrae, CA 94904-3017
Phone (415) 461-9093
Other providers in Greenbrae, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 13, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.