Active NPI
Kevin Zachary Fatholahi, PHARMD
- Pharmacist
- West Chester, PA
National Provider Identifier
1417522038
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RP455331
- Practice address
- 1040 W Chester Pike
West Chester, PA 19382-5003 - Phone
- (610) 344-7469
- NPI assigned
- May 25, 2021
- 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 | RP455331 | PA | Primary |
Addresses
Primary practice location
1040 W Chester Pike
West Chester, PA 19382-5003
Mailing address
1040 W Chester Pike
West Chester, PA 19382-5003
Phone (978) 758-4667
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 |
|---|---|---|---|
| RP455331 | PA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pennsylvania CVS Pharmacy, L.L.C. | Past | Accepting new patients | |
| Pennsylvania CVS Pharmacy, L.L.C. | Past | Accepting new patients | |
| Pennsylvania CVS Pharmacy LLC | Past | Accepting new patients |
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1621900800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1724371200000",
"number": "1417522038",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1040 W CHESTER PIKE",
"city": "WEST CHESTER",
"state": "PA",
"postal_code": "193825003",
"telephone_number": "978-758-4667"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1040 W CHESTER PIKE",
"city": "WEST CHESTER",
"state": "PA",
"postal_code": "193825003",
"telephone_number": "610-344-7469"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FATHOLAHI",
"first_name": "KEVIN",
"middle_name": "ZACHARY",
"name_prefix": "Dr.",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-05-25",
"last_updated": "2024-08-23",
"certification_date": "2024-08-23",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "PA",
"license": "RP455331",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West Chester, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.