Provider Demographics
NPI:1427357235
Name:GOMAA, AMR MOHAMED
Entity Type:Individual
Prefix:
First Name:AMR
Middle Name:MOHAMED
Last Name:GOMAA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4957 CARLISLE PIKE
Mailing Address - Street 2:
Mailing Address - City:MECHANICSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17050-3025
Mailing Address - Country:US
Mailing Address - Phone:717-975-0117
Mailing Address - Fax:717-975-2312
Practice Address - Street 1:4957 CARLISLE PIKE
Practice Address - Street 2:
Practice Address - City:MECHANICSBURG
Practice Address - State:PA
Practice Address - Zip Code:17050-3025
Practice Address - Country:US
Practice Address - Phone:717-975-0117
Practice Address - Fax:717-975-2312
Is Sole Proprietor?:No
Enumeration Date:2011-03-18
Last Update Date:2011-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP440882183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist