Provider Demographics
NPI:1689973828
Name:BADWI, BISHOY SAMIR HANNA (RPH)
Entity Type:Individual
Prefix:
First Name:BISHOY
Middle Name:SAMIR HANNA
Last Name:BADWI
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9835 MONROE RD
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28270-1471
Mailing Address - Country:US
Mailing Address - Phone:704-847-8892
Mailing Address - Fax:704-849-7228
Practice Address - Street 1:9835 MONROE RD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28270-1471
Practice Address - Country:US
Practice Address - Phone:704-847-8892
Practice Address - Fax:704-849-7228
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-26
Last Update Date:2011-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC18510183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist