MEDICARE: DR. AHMED MOHAMMED HEGAZY PHARMD

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	183500000X	Pharmacist	03132010	OH

General Provider Information

NPI Number	:	1639428584
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AHMED MOHAMMED HEGAZY PHARMD

Provider Business Mailing Address
First Line	:	7857 HEDINGHAM RD
Second Line	:
City	:	SYLVANIA
State	:	OH
Zip	:	43560-1013
Country	:	US
Telephone Number	:	419-824-3443
Fax Number	:

Provider Business Practice Location Address
First Line	:	625 ELMIRA RD
Second Line	:
City	:	VACAVILLE
State	:	CA
Zip	:	95687-4655
Country	:	US
Telephone Number	:	707-451-0285
Fax Number	:

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

Provider Enumeration Date	:	09/06/2012
Last Update Date	:	05/02/2019

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