=====================================================
General NPI Number Information
=====================================================
NPI Number | 1982157616
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | EMAN ABDALHAMID
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/29/2016
-----------------------------------------------------
Last Update Date | 07/29/2016
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 746 W UNIVERSITY DR
-----------------------------------------------------
City | MESA
-----------------------------------------------------
State | AZ
-----------------------------------------------------
Zip | 85201-5613
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 480-668-6350
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4662 W IVANHOE ST
-----------------------------------------------------
City | CHANDLER
-----------------------------------------------------
State | AZ
-----------------------------------------------------
Zip | 85226-2083
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 205-643-3751
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 183500000X
-----------------------------------------------------
Taxonomy Name | Pharmacist
-----------------------------------------------------
License Number | S021906
-----------------------------------------------------
License Number State | AZ
-----------------------------------------------------