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NPI Code Detail

MEDICARE: IBRAHIM A ABDELWAHAB PHARM.D

MEDICARE: IBRAHIM A ABDELWAHAB 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
1183500000XPharmacist025103LA

General Provider Information

NPI Number : 1013785427
Entity Type Code : Individual
Provider Name (Legal Business Name) : IBRAHIM A ABDELWAHAB PHARM.D
Provider Business Mailing Address
First Line : 2041 TITAN ST
Second Line :
City : HARVEY
State : LA
Zip : 70058-2957
Country : US
Telephone Number : 504-881-5734
Fax Number :
Provider Business Practice Location Address
First Line : 2001 CAROL SUE AVE
Second Line :
City : GRETNA
State : LA
Zip : 70056-4445
Country : US
Telephone Number : 504-366-1535
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/14/2023
Last Update Date : 12/14/2023

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