Active NPI
Hirut Fasil, RP
- Community/Retail Pharmacy
- Lincoln, NE
National Provider Identifier
1639824832
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- License
- 2411
- Practice address
- 1404 Superior St
Lincoln, NE 68521-1945 - Phone
- (402) 477-2622
- Fax
- (402) 477-3751
- NPI assigned
- Feb 16, 2022
- Last updated
- Feb 16, 2022
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Community/Retail Pharmacy | 3336C0003X | 2411 | NE | Primary |
Addresses
Primary practice location
1404 Superior St
Lincoln, NE 68521-1945
Mailing address
1404 Superior St
Lincoln, NE 68521-1945
Phone (402) 477-2622
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
| License | State | Type | Specialty |
|---|---|---|---|
| 2411 | NE | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Community/Retail Pharmacy | Past | Accepting new patients |
| Walgreen Co | Community/Retail Pharmacy | 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": "1644969600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1644969600000",
"number": "1639824832",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1404 SUPERIOR ST",
"city": "LINCOLN",
"state": "NE",
"postal_code": "685211945",
"telephone_number": "402-477-2622",
"fax_number": "402-477-3751"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1404 SUPERIOR ST",
"city": "LINCOLN",
"state": "NE",
"postal_code": "685211945",
"telephone_number": "402-477-2622",
"fax_number": "402-477-3751"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FASIL",
"first_name": "HIRUT",
"credential": "RP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-02-16",
"last_updated": "2022-02-16",
"certification_date": "2022-02-16",
"status": "A"
},
"taxonomies": [
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": "NE",
"license": "2411",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lincoln, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.