Individual provider Active NPI

Ehab K Mikhael, RPH

  • Pharmacist
  • Surfside Beach, SC
National Provider Identifier
1831401330
Registry record updated Mar 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
12869 Issued in SC
Practice address
2701 Dick Pond Rd
Surfside Beach, SC 29575-5510
Phone
(843) 650-6800
NPI assigned
Jul 13, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 11, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 12869 SC Primary

Addresses

Primary practice location

2701 Dick Pond Rd
Surfside Beach, SC 29575-5510

Mailing address

1601 Church St
Conway, SC 29526-2959
Phone (843) 488-2000

Other names 1

  • Ehab K.M. Moawad Former name

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

LicenseStateTypeSpecialty
12869SCMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Walgreen Co PastSince Mar 16, 2021 Accepting new patients
Walgreen Co PastSince Mar 16, 2021 Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1278979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615420800000",
    "number": "1831401330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 CHURCH ST",
            "city": "CONWAY",
            "state": "SC",
            "postal_code": "295262959",
            "telephone_number": "843-488-2000",
            "fax_number": "843-488-2222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2701 DICK POND RD",
            "city": "SURFSIDE BEACH",
            "state": "SC",
            "postal_code": "295755510",
            "telephone_number": "843-650-6800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIKHAEL",
        "first_name": "EHAB",
        "middle_name": "K",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-07-13",
        "last_updated": "2021-03-11",
        "certification_date": "2021-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "SC",
            "license": "12869",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EHAB",
            "last_name": "MOAWAD",
            "middle_name": "K.M.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Surfside Beach, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2021; 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.