Healthcare Provider Details

I. General information

NPI: 1811584592
Provider Name (Legal Business Name): MOHAMMAD HASIBUR RAHMAN PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/28/2020
Last Update Date: 12/28/2020
Certification Date: 12/28/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1700 6TH AVE S
BIRMINGHAM AL
35233-1802
US

IV. Provider business mailing address

1700 6TH AVE S
BIRMINGHAM AL
35233-1802
US

V. Phone/Fax

Practice location:
  • Phone: 205-975-2381
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835X0200X
TaxonomyOncology Pharmacist
License Number17546
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: