Mohammedrazavi Momin, PHARM.D

Primary specialty

PharmacistTaxonomy code 183500000X

License

RPH031659 Issued in GA

Practice address

668 Main St
Thomson, GA 30824-7416

Phone

(706) 595-1667

NPI assigned

Apr 15, 2020

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

Practice roles

Locations

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.

• Walgreen Co

  dba Walgreens #11995

  • Pharmacy
  • Thomson, GA
  • NPI 1386804896
  NPD
• Walgreen Co

  dba Walgreens #21605

  • Pharmacy
  • Longview, TX
  • NPI 1629956545
  NPD (past)

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

{
    "created_epoch": "1586908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671667200000",
    "number": "1457970865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "920 INNISBROOK DR",
            "city": "EVANS",
            "state": "GA",
            "postal_code": "308093493"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "668 MAIN ST",
            "city": "THOMSON",
            "state": "GA",
            "postal_code": "308247416",
            "telephone_number": "706-595-1667"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "672 Furys Ferry Rd",
            "address_purpose": "LOCATION",
            "city": "Augusta",
            "state": "GA",
            "postal_code": "309078945",
            "country_code": "US",
            "telephone_number": "706-210-7505",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOMIN",
        "first_name": "MOHAMMEDRAZAVI",
        "name_prefix": "Dr.",
        "credential": "PHARM.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-04-15",
        "last_updated": "2022-12-22",
        "certification_date": "2022-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "SC",
            "license": "PH42144",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "GA",
            "license": "RPH031659",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Terry W. Miller, O.D.
• Mind Is Unique Counseling Services LLC
• Jennifer B Mobley, NP
• Labranda Mobley
• Lisa Modlin, LPC GEORGIA
• Mallory Mayers Montes, DNP, FNP-C
• Nilka D Morello, OTR
• Morgan Medical Supplies, LLC
• Jacqueline Morgan, LPC, NCC, CAADC
• Morgan, Miloni and Associates (Innovation Behavioral Health)

• Pharmacist in Thomson, GA
• Providers in Thomson, GA by specialty
• Pharmacist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 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.

Verify at the official NPI Registry.