Active NPI
Maryam N Khan, RPH
- Pharmacist
- Clovis, CA
National Provider Identifier
1790072197
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RPH 54359
- Practice address
- 1155 Shaw Ave
Clovis, CA 93612-3928 - Phone
- (559) 297-4198
- Fax
- (559) 297-7388
- NPI assigned
- Jul 6, 2011
- Sex
- Female
- 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 | RPH 54359 | CA | Primary |
Addresses
Primary practice location
1155 Shaw Ave
Clovis, CA 93612-3928
Mailing address
1155 Shaw Avenue Sierra Pavilion
Rite Aid 1155 Shaw Ave
Clovis, CA 93612
Phone (559) 297-4198
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RPH 54359 | CA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Thrifty Payless Inc | 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.
-
dba Rite Aid Pharmacy 06833
- Community/Retail Pharmacy
- Winchester, CA
- NPI 1437874062
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1309910400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1309910400000",
"number": "1790072197",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1155 SHAW AVENUE SIERRA PAVILION",
"address_2": "RITE AID 1155 SHAW AVE",
"city": "CLOVIS",
"state": "CA",
"postal_code": "93612",
"telephone_number": "559-297-4198",
"fax_number": "559-297-7388"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1155 SHAW AVE",
"city": "CLOVIS",
"state": "CA",
"postal_code": "936123928",
"telephone_number": "559-297-4198",
"fax_number": "559-297-7388"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KHAN",
"first_name": "MARYAM",
"middle_name": "N",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-07-06",
"last_updated": "2011-07-06",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "RPH 54359",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Clovis, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.