Individual provider Active NPI

Mohamed Elmubarak, RPH

  • Pharmacist
  • Phoenix, AZ
National Provider Identifier
1871243477
Registry record updated Mar 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
S025328 Issued in AZ
Practice address
18460 N 7TH St
Phoenix, AZ 85022-1108
Phone
(602) 993-5781
NPI assigned
Mar 25, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X S025328 AZ Primary

Addresses

Primary practice location

18460 N 7TH St
Phoenix, AZ 85022-1108

Mailing address

3945 W Geronimo St
Chandler, AZ 85226-4995
Phone (714) 331-0309

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
S025328AZMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Visionmedmd LLC Current Accepting new patients
German Dobson CVS LLC PastSince Mar 27, 2022 Accepting new patients
German Dobson CVS LLC PastSince Mar 27, 2022 Accepting new patients

Organizations & group practices 3

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": "1648166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648166400000",
    "number": "1871243477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3945 W GERONIMO ST",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852264995",
            "telephone_number": "714-331-0309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18460 N 7TH ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850221108",
            "telephone_number": "602-993-5781"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELMUBARAK",
        "first_name": "MOHAMED",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-03-25",
        "last_updated": "2022-03-25",
        "certification_date": "2022-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "AZ",
            "license": "S025328",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2022; 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.