MEDICARE: DR. ABEDALHAKEEM ABUKHALIL PHARM.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3336C0003X	Community/Retail Pharmacy	03328847	OH
2	1835P2201X	Ambulatory Care Pharmacist	03328847	OH
3	183500000X	Pharmacist	03328847	OH

General Provider Information

NPI Number	:	1427659937
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ABEDALHAKEEM ABUKHALIL PHARM.D.

Provider Business Mailing Address
First Line	:	401 CLEVELAND ST
Second Line	:
City	:	ELYRIA
State	:	OH
Zip	:	44035-6143
Country	:	US
Telephone Number	:	440-309-4036
Fax Number	:	440-309-4037

Provider Business Practice Location Address
First Line	:	14529 PURITAS AVE
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44135-2813
Country	:	US
Telephone Number	:	216-476-1400
Fax Number	:	216-476-1401

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/03/2020
Last Update Date	:	06/11/2026

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