Active NPI
Georges David Tabbal, PHARMD
- Pharmacist
- Bloomington, IN
National Provider Identifier
1740886324
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 26022145A
- Practice address
- 510 S College Mall Rd
Bloomington, IN 47401-6315 - Phone
- (812) 336-0279
- Fax
- (812) 335-9347
- NPI assigned
- Dec 8, 2020
- 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 | 26022145A | IN | Primary |
Addresses
Primary practice location
510 S College Mall Rd
Bloomington, IN 47401-6315
Mailing address
510 S College Mall Rd
Bloomington, IN 47401-6315
Phone (812) 336-0279
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
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 26022145A | IN | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1607385600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1607558400000",
"number": "1740886324",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "510 S COLLEGE MALL RD",
"city": "BLOOMINGTON",
"state": "IN",
"postal_code": "474016315",
"telephone_number": "812-336-0279",
"fax_number": "812-335-9347"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "510 S COLLEGE MALL RD",
"city": "BLOOMINGTON",
"state": "IN",
"postal_code": "474016315",
"telephone_number": "812-336-0279",
"fax_number": "812-335-9347"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TABBAL",
"first_name": "GEORGES",
"middle_name": "DAVID",
"name_prefix": "Dr.",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-12-08",
"last_updated": "2020-12-10",
"certification_date": "2020-12-10",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "IN",
"license": "26022145A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bloomington, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.