Active NPI
Marian Mamdouh Abdalla Hann Elmalah
- Pharmacist
- Fort Worth, TX
National Provider Identifier
1982996005
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 03329091
- Practice address
- 3525 Sycamore School Rd
Fort Worth, TX 76133-7805 - Phone
- (817) 346-4457
- NPI assigned
- May 8, 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 | 03329091 | OH | Primary |
Addresses
Primary practice location
3525 Sycamore School Rd
Fort Worth, TX 76133-7805
Mailing address
2513 Wildwood Way
Keller, TX 76262-8811
Phone (216) 235-4332
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
| License | State | Type | Specialty |
|---|---|---|---|
| 03329091 | OH | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Albertsons LLC | Past | Accepting new patients | |
| Albertsons LLC | Past | 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.
-
- Community/Retail Pharmacy
- Ft Worth, TX
- NPI 1477590800
-
- Community/Retail Pharmacy
- Ardmore, OK
- NPI 1134958457
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1304812800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1458000000000",
"number": "1982996005",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2513 WILDWOOD WAY",
"city": "KELLER",
"state": "TX",
"postal_code": "762628811",
"telephone_number": "216-235-4332"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3525 SYCAMORE SCHOOL RD",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761337805",
"telephone_number": "817-346-4457"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELMALAH",
"first_name": "MARIAN",
"middle_name": "MAMDOUH ABDALLA HANN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-05-08",
"last_updated": "2016-03-15",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "OH",
"license": "03329091",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Worth, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.