Individual
AHMAD IBRAHIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
5214-30 BALTIMORE AVE, PHILADELPHIA, PA 19143
(267) 474-5909
Mailing address
4519 SAINT MALACHYS WAY, PHILADELPHIA, PA 19139-2857
(267) 474-5909
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RP446767
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RP446767
PHARMACY
PA
Enumeration date
07/11/2014
Last updated
07/11/2014
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