Individual provider Active NPI

Wassim Gharib, PHARMD

  • Pharmacist
  • Taylor, MI
National Provider Identifier
1477164135
Registry record updated Jun 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
5302043571 Issued in MI
Practice address
23241 Eureka Rd
Taylor, MI 48180-5240
Phone
(734) 287-3880
Fax
(734) 287-0633
NPI assigned
Aug 14, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 6, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 5302043571 MI Primary

Addresses

Primary practice location

23241 Eureka Rd
Taylor, MI 48180-5240

Mailing address

23241 Eureka Rd
Taylor, MI 48180-5240
Phone (734) 287-3880

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

LicenseStateTypeSpecialty
5302043571MIMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Wyandotte Pharmacy, Inc. PastSince Jul 21, 2024 Accepting new patients

Organizations & group practices 1

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": "1597363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686009600000",
    "number": "1477164135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23241 EUREKA RD",
            "city": "TAYLOR",
            "state": "MI",
            "postal_code": "481805240",
            "telephone_number": "734-287-3880",
            "fax_number": "734-287-0633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23241 EUREKA RD",
            "city": "TAYLOR",
            "state": "MI",
            "postal_code": "481805240",
            "telephone_number": "734-287-3880",
            "fax_number": "734-287-0633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GHARIB",
        "first_name": "WASSIM",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-08-14",
        "last_updated": "2023-06-06",
        "certification_date": "2023-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MI",
            "license": "5302043571",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Taylor, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2023; 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.