Provider Demographics
NPI:1467790139
Name:IBEX DEAD SEA IMPORTS
Entity Type:Organization
Organization Name:IBEX DEAD SEA IMPORTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:SHAY
Authorized Official - Middle Name:
Authorized Official - Last Name:ZAHARI
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:301-300-5740
Mailing Address - Street 1:6 MARTHA CT
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852-4108
Mailing Address - Country:US
Mailing Address - Phone:301-881-1555
Mailing Address - Fax:301-881-1599
Practice Address - Street 1:11520 ROCKVILLE PIKE STE E
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852-2763
Practice Address - Country:US
Practice Address - Phone:301-300-5740
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-30
Last Update Date:2013-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDP058993336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDP05899OtherPHARMACY LICENSE