Individual provider Active NPI

Mahdi Fehmi

  • Pharmacist
  • Bayamon, PR
National Provider Identifier
1790936102
Registry record updated Oct 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
5307 Issued in PR
Practice address
7570 Kmart Pharmacy de Diego Expressway
Plaza Rio Hondo
Bayamon, PR 00961
Phone
(787) 795-5088
NPI assigned
Oct 3, 2008
Last updated
Oct 3, 2008By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 3, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 5307 PR Primary

Addresses

Primary practice location

7570 Kmart Pharmacy de Diego Expressway
Plaza Rio Hondo
Bayamon, PR 00961

Mailing address

1152 Calle Lopez Sicardo
Urb San Agustin
San Juan, PR 00923-3223
Phone (787) 553-5561

Other identifiers 1

IdentifierTypeStateIssuer
5307OtherPRSTATE LICENSE

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

State licenses

LicenseStateTypeSpecialty
5307PRMDPharmacy Technician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1222992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1222992000000",
    "number": "1790936102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1152 CALLE LOPEZ SICARDO",
            "address_2": "URB SAN AGUSTIN",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009233223",
            "telephone_number": "787-553-5561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7570 KMART PHARMACY DE DIEGO EXPRESSWAY",
            "address_2": "PLAZA RIO HONDO",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "00961",
            "telephone_number": "787-795-5088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FEHMI",
        "first_name": "MAHDI",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-10-03",
        "last_updated": "2008-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "PR",
            "license": "5307",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "5307",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bayamon, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.