Organization Active NPI

Habnael Inc

  • Community/Retail Pharmacy
  • Baltimore, MD
National Provider Identifier
1417453325
Registry record updated Jan 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
HABNAEL INC
Doing business as
Greektown Pharmacy & Mini Mart
Practice address
4501 Eastern Ave
Baltimore, MD 21224-4416
Phone
(202) 460-7703
Fax
(443) 941-9011
NPI assigned
Apr 2, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2021

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

Authorized official

Name
Dr. Hiwot FekadeNPI 1750719324
Title
Manager
Phone
(443) 759-7062

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X Primary
Long Term Care Pharmacy 3336L0003X

Addresses

Primary practice location

4501 Eastern Ave
Baltimore, MD 21224-4416

Mailing address

4501 Eastern Ave
Baltimore, MD 21224-4416
Phone (443) 759-7062

Other identifiers 1

IdentifierTypeStateIssuer
362019100MedicaidMD

Other names 1

  • Greektown Pharmacy & Mini Mart Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
21D2317296Habnael Inc Dba Greektown Pharmacy & Mini Mart4501 Eastern Ave, Baltimore, MD 21224Certificate of waiverJan 21, 2027

National Provider Directory

National Provider Directory

Locations

4501 Eastern Ave
Baltimore, MD 21224
Phone (202) 460-7703

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1522627200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1611878400000",
    "number": "1417453325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4501 EASTERN AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212244416",
            "telephone_number": "443-759-7062",
            "fax_number": "443-941-9011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4501 EASTERN AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212244416",
            "telephone_number": "202-460-7703",
            "fax_number": "443-941-9011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HABNAEL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-02",
        "last_updated": "2021-01-29",
        "certification_date": "2021-01-29",
        "status": "A",
        "authorized_official_last_name": "FEKADE",
        "authorized_official_first_name": "HIWOT",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "443-759-7062",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "362019100",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Greektown Pharmacy & Mini Mart",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.