Organization Active NPI

Pharmacy of America IX Inc

  • Community/Retail Pharmacy
  • Philadelphia, PA
National Provider Identifier
1487343943
Registry record updated May 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
PHARMACY OF AMERICA IX INC
Practice address
1000 Cottman Ave
Philadelphia, PA 19111-3644
Phone
(267) 237-1188
NPI assigned
May 2, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 2, 2023

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

Authorized official

Name
Dr. Sabri Ibrahim, PHARM D.
Title
President & Ceo
Phone
(267) 237-1188

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X Primary

Addresses

Primary practice location

1000 Cottman Ave
Philadelphia, PA 19111-3644

Mailing address

4654 N 5TH St
Philadelphia, PA 19140-1420

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240727000309 PA Part B Supplier - Pharmacy 6608312582 Practice locations: Philadelphia, PA

National Provider Directory

National Provider Directory

Locations

1000 Cottman Ave
Philadelphia, PA 19111
Phone (215) 770-7869

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1682985600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1682985600000",
    "number": "1487343943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4654 N 5TH ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191401420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 COTTMAN AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191113644",
            "telephone_number": "267-237-1188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHARMACY OF AMERICA IX INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-02",
        "last_updated": "2023-05-02",
        "certification_date": "2023-05-02",
        "status": "A",
        "authorized_official_last_name": "IBRAHIM",
        "authorized_official_first_name": "SABRI",
        "authorized_official_title_or_position": "PRESIDENT & CEO",
        "authorized_official_telephone_number": "267-237-1188",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHARM D."
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.