Provider Demographics
NPI:1215597893
Name:AHMED, EIHAB M (PHARMD)
Entity Type:Individual
Prefix:
First Name:EIHAB
Middle Name:M
Last Name:AHMED
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 1:12020 N NEWPORT HWY
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99218-1655
Mailing Address - Country:US
Mailing Address - Phone:509-466-3315
Mailing Address - Fax:
Practice Address - Street 1:12020 N NEWPORT HWY
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99218-1655
Practice Address - Country:US
Practice Address - Phone:509-466-3315
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-17
Last Update Date:2019-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH60953468183500000X
IDP8393183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAPH60953468OtherWASHINGTON DEPARTMENT OF HEALTH
IDP8393OtherPHARMACIST LICENSE