Active NPI
Maher Shenouda, PHARM.D
- Pharmacist
- Kotzebue, AK
National Provider Identifier
1417474644
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- S017037
- Practice address
- 436 5TH Ave
Kotzebue, AK 99752-9975 - Phone
- (907) 442-7457
- Fax
- (907) 442-7245
- NPI assigned
- Aug 28, 2017
- Last updated
- Jul 19, 2022
- 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 | S017037 | AZ | Primary |
Addresses
Primary practice location
436 5TH Ave
Kotzebue, AK 99752-9975
Mailing address
7177 W Fleetwood LN
Glendale, AZ 85303-7607
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
| License | State | Type | Specialty |
|---|---|---|---|
| S017037 | AZ | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | 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": "1503878400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658188800000",
"number": "1417474644",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7177 W FLEETWOOD LN",
"city": "GLENDALE",
"state": "AZ",
"postal_code": "853037607"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "436 5TH AVE",
"city": "KOTZEBUE",
"state": "AK",
"postal_code": "997529975",
"telephone_number": "907-442-7457",
"fax_number": "907-442-7245"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHENOUDA",
"first_name": "MAHER",
"credential": "PHARM.D",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-08-28",
"last_updated": "2022-07-19",
"certification_date": "2022-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Pharmacist",
"state": "AZ",
"license": "S017037",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kotzebue, AK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.