Active NPI
Canaan David Khoury II, PHARMD
- Pharmacist
- Roslindale, MA
National Provider Identifier
1558644229
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PH233667
- Practice address
- 972 American Legion Hwy
Roslindale, MA 02131-4701 - Phone
- (617) 327-0106
- NPI assigned
- Sep 20, 2011
- Last updated
- Oct 7, 2011
- Sex
- Male
- Sole proprietor
- Yes
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 | PH233667 | MA | Primary |
Addresses
Primary practice location
972 American Legion Hwy
Roslindale, MA 02131-4701
Mailing address
210 Bear Hill Rd
401
Waltham, MA 02451-1025
Phone (781) 890-2362
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
| License | State | Type | Specialty |
|---|---|---|---|
| PH233667 | MA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Eastern Co Inc | Past | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1316476800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1317945600000",
"number": "1558644229",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "210 BEAR HILL RD",
"address_2": "401",
"city": "WALTHAM",
"state": "MA",
"postal_code": "024511025",
"telephone_number": "781-890-2362"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "972 AMERICAN LEGION HWY",
"city": "ROSLINDALE",
"state": "MA",
"postal_code": "021314701",
"telephone_number": "617-327-0106"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KHOURY",
"first_name": "CANAAN",
"middle_name": "DAVID",
"name_prefix": "Dr.",
"name_suffix": "II",
"credential": "PHARMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-09-20",
"last_updated": "2011-10-07",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MA",
"license": "PH233667",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Roslindale, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 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.