Active NPI
Ammar Salah Eddin Mousa
- Pharmacist
- Green Bay, WI
National Provider Identifier
1609782077
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 23616-40
- Practice address
- 1401 E Mason St
Green Bay, WI 54301-3330 - Phone
- (920) 435-7679
- NPI assigned
- Aug 24, 2026
- Last updated
- Aug 24, 2026
- Sex
- Male
- Sole proprietor
- No
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 | 23616-40 | WI | Primary |
Addresses
Primary practice location
1401 E Mason St
Green Bay, WI 54301-3330
Mailing address
1401 E Mason St
Green Bay, WI 54301-3330
Phone (920) 435-7679
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
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, 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": "1787529600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1787529600000",
"number": "1609782077",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1401 E MASON ST",
"city": "GREEN BAY",
"state": "WI",
"postal_code": "543013330",
"telephone_number": "920-435-7679"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1401 E MASON ST",
"city": "GREEN BAY",
"state": "WI",
"postal_code": "543013330",
"telephone_number": "920-435-7679"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOUSA",
"first_name": "AMMAR",
"middle_name": "SALAH EDDIN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2026-08-24",
"last_updated": "2026-08-24",
"certification_date": "2026-08-24",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WI",
"license": "23616-40",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Green Bay, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.