Active NPI
Amgad Shawky Boulus, RPH
- Pharmacist
- Tulare, CA
National Provider Identifier
1740564434
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 65170
- Practice address
- 1418 E Prosperity Ave
Tulare, CA 93274-8054 - Phone
- (559) 684-7963
- Fax
- (559) 684-7967
- NPI assigned
- Sep 29, 2011
- 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 | 65170 | CA | Primary |
Addresses
Primary practice location
1418 E Prosperity Ave
Tulare, CA 93274-8054
Mailing address
1418 E Prosperity Ave
Tulare, CA 93274-8054
Phone (559) 684-7963
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | 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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1317254400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1375228800000",
"number": "1740564434",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1418 E PROSPERITY AVE",
"city": "TULARE",
"state": "CA",
"postal_code": "932748054",
"telephone_number": "559-684-7963",
"fax_number": "559-684-7967"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1418 E PROSPERITY AVE",
"city": "TULARE",
"state": "CA",
"postal_code": "932748054",
"telephone_number": "559-684-7963",
"fax_number": "559-684-7967"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOULUS",
"first_name": "AMGAD",
"middle_name": "SHAWKY",
"name_prefix": "Mr.",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-09-29",
"last_updated": "2013-07-31",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "65170",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tulare, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.