Individual provider Active NPI

Maha Magdy Banoub, RPH

  • Pharmacist
  • Bothell, WA
National Provider Identifier
1669027017
Registry record updated Aug 2, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PH60890026 Issued in WA
Practice address
19410 Meridian PL W
Bothell, WA 98012-9710
Phone
(919) 903-5156
NPI assigned
Aug 2, 2019
Last updated
Aug 2, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PH60890026 WA Primary

Addresses

Primary practice location

19410 Meridian PL W
Bothell, WA 98012-9710

Mailing address

19410 Meridian PL W
Bothell, WA 98012-9710
Phone (919) 903-5156

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
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
PH60890026WAMDPharmacist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1564704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564704000000",
    "number": "1669027017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19410 MERIDIAN PL W",
            "city": "BOTHELL",
            "state": "WA",
            "postal_code": "980129710",
            "telephone_number": "919-903-5156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19410 MERIDIAN PL W",
            "city": "BOTHELL",
            "state": "WA",
            "postal_code": "980129710",
            "telephone_number": "919-903-5156"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANOUB",
        "first_name": "MAHA",
        "middle_name": "MAGDY",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-02",
        "last_updated": "2019-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WA",
            "license": "PH60890026",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bothell, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2019; 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.