Active NPI
Aws Atallah
- Pharmacist
- Chelsea, MI
National Provider Identifier
1669144564
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 5302413812
- Practice address
- 935 S Main St
Chelsea, MI 48118-1330 - Phone
- (734) 475-2222
- NPI assigned
- Sep 30, 2021
- Last updated
- Sep 30, 2021
- 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 | 5302413812 | MI | Primary |
Addresses
Primary practice location
935 S Main St
Chelsea, MI 48118-1330
Mailing address
40963 Kingsley LN
Novi, MI 48377-1629
Phone (248) 410-8184
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 |
|---|---|---|---|
| 5302413812 | MI | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Woodward Detroit CVS, L.L.C. | Past | Accepting new patients |
Organizations & group practices 1
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": "1632960000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1632960000000",
"number": "1669144564",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "40963 KINGSLEY LN",
"city": "NOVI",
"state": "MI",
"postal_code": "483771629",
"telephone_number": "248-410-8184"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "935 S MAIN ST",
"city": "CHELSEA",
"state": "MI",
"postal_code": "481181330",
"telephone_number": "734-475-2222"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ATALLAH",
"first_name": "AWS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-09-30",
"last_updated": "2021-09-30",
"certification_date": "2021-09-30",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MI",
"license": "5302413812",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chelsea, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.