Active NPI
Tolefac Akem Tabang
- Ambulatory Care Pharmacist
- Kayenta, AZ
National Provider Identifier
1710423025
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ambulatory Care Pharmacist
- License
- 0202215386
- Practice address
- 1/2 Mile S of MP 394.3
Kayenta Health Center
Kayenta, AZ 86033 - Phone
- (240) 899-8677
- NPI assigned
- Jan 10, 2017
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Ambulatory Care Pharmacist | 1835P2201X | 0202215386 | VA | Primary |
Addresses
Primary practice location
1/2 Mile S of MP 394.3
Kayenta Health Center
Kayenta, AZ 86033
Mailing address
1/2 Mile S of MP 394.3
Kayenta, AZ 86033
Phone (240) 899-8677
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 |
|---|---|---|---|
| 0202215386 | VA | MD | Ambulatory Care Pharmacist |
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.
-
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- Lanham, MD
- NPI 1851731137
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1484006400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1484006400000",
"number": "1710423025",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1/2 MILE S OF MP 394.3",
"city": "KAYENTA",
"state": "AZ",
"postal_code": "86033",
"telephone_number": "240-899-8677"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1/2 MILE S OF MP 394.3",
"address_2": "KAYENTA HEALTH CENTER",
"city": "KAYENTA",
"state": "AZ",
"postal_code": "86033",
"telephone_number": "240-899-8677"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TABANG",
"first_name": "TOLEFAC",
"middle_name": "AKEM",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-01-10",
"last_updated": "2017-01-10",
"status": "A"
},
"taxonomies": [
{
"code": "1835P2201X",
"taxonomy_group": "",
"desc": "Pharmacist, Ambulatory Care",
"state": "VA",
"license": "0202215386",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kayenta, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.