Mussie Mesfen Tadese

Primary specialty

PharmacistTaxonomy code 183500000X

License

PS58905 Issued in FL

Practice address

10870 Overseas Hwy
Marathon, FL 33050-3455

Phone

(305) 743-6929

NPI assigned

Mar 22, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

  • Pharmacy
  • Marathon, FL
  • NPI 1154336261
  NPD (past)
• Walgreen Co

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

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

{
    "created_epoch": "1553212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553212800000",
    "number": "1508326810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 COCO PLUM DR APT 804",
            "city": "MARATHON",
            "state": "FL",
            "postal_code": "330504044",
            "telephone_number": "206-455-3782"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10870 OVERSEAS HWY",
            "city": "MARATHON",
            "state": "FL",
            "postal_code": "330503455",
            "telephone_number": "305-743-6929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TADESE",
        "first_name": "MUSSIE",
        "middle_name": "MESFEN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-22",
        "last_updated": "2019-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS58905",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah Lester Sullivan, B.S.
• Susana May MD LLC
• Dana Word Swann, LPN
• Anne Swanson
• Charles W Sweeney, M.D.
• Christine Taggart, D.D.S.
• Lea Margaret Thies, FNP
• Thomas Operchal MD PA
• Lavida Judith Thomas-Richardson, MD
• Thomas Lee Thompson, D.D.S.,M.S.

• Pharmacist in Marathon, FL
• Providers in Marathon, FL by specialty
• Pharmacist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2019; 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.