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General NPI Number Information
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NPI Number | 1184325219
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Entity Type | Individual
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Provider Name | FATIMA A KHAJA PHARMD, PHD
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Gender | Female
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Dates
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Enumeration Date | 03/15/2023
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Last Update Date | 03/15/2023
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Provider Practice Location Address
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Address Line | 3104 W 23RD ST
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City | PANAMA CITY
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State | FL
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Zip | 32405-1829
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Country | US
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Telephone | 850-215-7455
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Fax |
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Provider Business Mailing Address
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Address Line | 461 WAHOO RD
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City | PANAMA CITY BEACH
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State | FL
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Zip | 32408-7266
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Country | US
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Telephone | 847-338-7975
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1835P2201X
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Taxonomy Name | Ambulatory Care Pharmacist
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License Number | 051.294738
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PS62508
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License Number State | FL
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