Provider Demographics
NPI:1043822232
Name:AHMAD, MOBAHIL (PHARMD)
Entity Type:Individual
Prefix:
First Name:MOBAHIL
Middle Name:
Last Name:AHMAD
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 ST JUDE WAY UNIT C
Mailing Address - Street 2:
Mailing Address - City:BETHLEHEM
Mailing Address - State:NH
Mailing Address - Zip Code:03574-4157
Mailing Address - Country:US
Mailing Address - Phone:408-874-5147
Mailing Address - Fax:
Practice Address - Street 1:274 DELLS RD
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:NH
Practice Address - Zip Code:03561-3513
Practice Address - Country:US
Practice Address - Phone:603-444-4193
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-19
Last Update Date:2020-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT033.0134429183500000X
NHPHCY-00952183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist