Individual provider Active NPI

Jad-Allah Khairallah

  • Pharmacist
  • Sacramento, CA
National Provider Identifier
1609249226
Registry record updated Nov 4, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
72313 Issued in CA
Practice address
400 Howe Ave
Sacramento, CA 95825-5507
Phone
(916) 929-9577
NPI assigned
Nov 4, 2015
Sex
Male
Sole proprietor
Yes

Organizations & group practices 2

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.

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

State licenses

LicenseStateTypeSpecialty
72313CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Longs Drug Stores California, L.L.C. Past Accepting new patients
Longs Drug Store California LLC Past Accepting new patients

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 72313 CA Primary

Addresses

NPPES NPI Registry

Primary practice location

400 Howe Ave
Sacramento, CA 95825-5507

Mailing address

400 Howe Ave
Sacramento, CA 95825-5507
Phone (916) 929-9577

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Nov 4, 2015.

{
    "created_epoch": "1446595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1446595200000",
    "number": "1609249226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 HOWE AVE",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958255507",
            "telephone_number": "916-929-9577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 HOWE AVE",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958255507",
            "telephone_number": "916-929-9577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAIRALLAH",
        "first_name": "JAD-ALLAH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-11-04",
        "last_updated": "2015-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "72313",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2015; 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.