Khaja Basheer Ahmed
Individual provider Active NPI Pharmacist · Phoenix, AZ
NPI 1962821538 · NPPES record last updated Apr 10, 2014
Key facts
- NPI
- 1962821538
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- S015076 (AZ)
- Practice address
- 4275 W Thomas Rd
Phoenix, AZ 85019-4334 - Phone
- (602) 272-5601
- NPI assigned
- Apr 10, 2014
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| S015076 | AZ | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| German Dobson CVS LLC | Past | Accepting new patients | |
| German Dobson CVS LLC | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | S015076 | AZ | Yes |
Addresses
Primary practice location
4275 W Thomas Rd
Phoenix, AZ 85019-4334
Mailing address
4275 W Thomas Rd
Phoenix, AZ 85019-4334
Phone (602) 272-5601
Other providers in Phoenix, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 10, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.