Active NPI
George Ibrahim
- Pharmacist
- Dayton, OH
National Provider Identifier
1457659666
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 03328603
- Practice address
- 4328 N Main St
Dayton, OH 45405-5013 - Phone
- (937) 274-1530
- Fax
- (937) 276-9704
- NPI assigned
- Mar 11, 2011
- Last updated
- Mar 11, 2011
- 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 | 03328603 | OH | Primary |
Addresses
Primary practice location
4328 N Main St
Dayton, OH 45405-5013
Mailing address
3512 Queen Victoria CT
Beavercreek, OH 45431-5706
Phone (937) 231-8145
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 |
|---|---|---|---|
| 03328603 | OH | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1299801600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1299801600000",
"number": "1457659666",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3512 QUEEN VICTORIA CT",
"city": "BEAVERCREEK",
"state": "OH",
"postal_code": "454315706",
"telephone_number": "937-231-8145",
"fax_number": "937-276-9704"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4328 N MAIN ST",
"city": "DAYTON",
"state": "OH",
"postal_code": "454055013",
"telephone_number": "937-274-1530",
"fax_number": "937-276-9704"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IBRAHIM",
"first_name": "GEORGE",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-03-11",
"last_updated": "2011-03-11",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "OH",
"license": "03328603",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dayton, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.