Individual provider Active NPI

Mohamed M Abdelgowad, RPH

  • Pharmacist
  • Carlstadt, NJ
National Provider Identifier
1710358627
Registry record updated Oct 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
28RI03683400 Issued in NJ
Practice address
326 Garden St
Carlstadt, NJ 07072-1626
Phone
(201) 716-2569
NPI assigned
Oct 18, 2015
Last updated
Oct 17, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 17, 2022

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

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 0202213943 VA
Pharmacist 183500000X 60844 TX
Pharmacist 183500000X 067564 NY
Pharmacist 183500000X RP456122 PA
Pharmacist 183500000X 5302413208 MI
Pharmacist 183500000X 44006 TN
Pharmacist 183500000X 28RI03683400 NJ Primary

Addresses

Primary practice location

326 Garden St
Carlstadt, NJ 07072-1626

Mailing address

326 Garden St Unit 2
Carlstadt, NJ 07072-1626
Phone (201) 716-2569

Other identifiers 1

IdentifierTypeStateIssuer
28RJ08589OtherNJIMMUNIZING PHARMACIST

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
5302413208MIMDPharmacist
28RI03683400NJMDPharmacist
067564NYMDPharmacist
RP456122PAMDPharmacist
44006TNMDPharmacist
60844TXMDPharmacist
0202213943VAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Clarks Town Pharmacy LLC Current Accepting new patients
Ourrx Consulting LLC Current Accepting new patients
Remedium Pharmacy, LLC Past Accepting new patients
Differx Pharmacy LLC PastSince Dec 1, 2020 Accepting new patients

Organizations & group practices 4

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": "1445126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665964800000",
    "number": "1710358627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "326 GARDEN ST UNIT 2",
            "city": "CARLSTADT",
            "state": "NJ",
            "postal_code": "070721626",
            "telephone_number": "201-716-2569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "326 GARDEN ST",
            "city": "CARLSTADT",
            "state": "NJ",
            "postal_code": "070721626",
            "telephone_number": "201-716-2569"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABDELGOWAD",
        "first_name": "MOHAMED",
        "middle_name": "M",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-10-18",
        "last_updated": "2022-10-17",
        "certification_date": "2022-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "VA",
            "license": "0202213943",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TX",
            "license": "60844",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "067564",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "PA",
            "license": "RP456122",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MI",
            "license": "5302413208",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TN",
            "license": "44006",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NJ",
            "license": "28RI03683400",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IMMUNIZING PHARMACIST",
            "identifier": "28RJ08589",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Carlstadt, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 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.

Verify at the official NPI Registry.