Siamak Mollaei, PHARM.D
Individual provider Active NPI Pharmacist · Pinehill, NM
NPI 1659996031 · NPPES record last updated Jun 11, 2020
Key facts
- NPI
- 1659996031
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- S023980 (AZ)
- Practice address
- Bureau of Indian Affair Route 125
Pinehill, NM 87357 - Phone
- (505) 775-3933
- NPI assigned
- Jun 11, 2020
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| S023980 | AZ | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | S023980 | AZ | Yes |
Addresses
Primary practice location
Bureau of Indian Affair Route 125
Pinehill, NM 87357
Mailing address
Bureau of Indian Affair Route 125
Pinehill, NM 87357
Phone (505) 775-3933
Other providers in Pinehill, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 11, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.