Omar Abazeed, PHARMD

Key facts

NPI

1780396358

Entity type

Individual (NPI type 1)

Primary specialty

Pharmacist 183500000X

License

5302414941 (MI)

Practice address

20250 W 7 Mile Rd
Detroit, MI 48219-3469

Phone

(313) 535-9755

Fax

(313) 535-9655

NPI assigned

Dec 15, 2022

Sex

Male

Sole proprietor

No

Organizations & group practices 2

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.

• Apollo Medical Pharmacy LLC Point of Service · Detroit, MI · NPI 1962801373
  NPD Authorized official
• Apollo Medical Pharmacy LLC Community/Retail Pharmacy · Detroit, MI · NPI 1639461551
  NPD

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

State licenses

Practice roles

Locations

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jun 30, 2024.

{
    "created_epoch": "1671062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719705600000",
    "number": "1780396358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20232 RIVER OAKS DR",
            "city": "DEARBORN HEIGHTS",
            "state": "MI",
            "postal_code": "481272763",
            "telephone_number": "313-525-1915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20250 W 7 MILE RD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482193469",
            "telephone_number": "313-535-9755",
            "fax_number": "313-535-9655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABAZEED",
        "first_name": "OMAR",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-12-15",
        "last_updated": "2024-06-30",
        "certification_date": "2024-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MI",
            "license": "5315237757",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MI",
            "license": "5302414941",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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