Omar Amigon, PHARM D. RPH
Individual provider Active NPI Pharmacist · Cedar Rapids, IA
NPI 1730811985 · NPPES record last updated Jun 27, 2022
Key facts
- NPI
- 1730811985
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 24423 (IA)
- Practice address
- 2645 Blairs Ferry Rd NE
Cedar Rapids, IA 52402-1802 - Phone
- (319) 393-2110
- NPI assigned
- Jun 27, 2022
- Sex
- Male
- Sole proprietor
- Yes
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, Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 24423 | IA | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist |
183500000X | 24423 | IA | Yes |
Addresses
Primary practice location
2645 Blairs Ferry Rd NE
Cedar Rapids, IA 52402-1802
Mailing address
2805 Water St
Columbus City, IA 52737-9468
Phone (319) 212-0142
Other providers in Cedar Rapids, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 27, 2022. 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.