Homam Kador

Individual provider Active NPI Pharmacist · Mahanoy, PA

NPI 1780142869 · NPPES record last updated Mar 7, 2019

Key facts

NPI
1780142869
Entity type
Individual (NPI type 1)
Primary specialty
Pharmacist 183500000X
License
RP453052 (PA)
Practice address
15 West Mahanoy City
Mahanoy, PA 17973
Phone
(579) 012-3542
NPI assigned
Mar 7, 2019
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

State licenses

LicenseStateTypeSpecialty
RP453052PAMDPharmacist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist
Group: 193400000X SINGLE SPECIALTY GROUP
183500000X RP453052 PA Yes

Addresses

Primary practice location

15 West Mahanoy City
Mahanoy, PA 17973

Mailing address

107 Lilly St Apt 2
Schuylkill Haven, PA 17972-1156
Phone (313) 375-9262

Sources for this page

Verify at the official NPI Registry.