Provider Demographics
NPI:1790406288
Name:HAMED, GADA (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:GADA
Middle Name:
Last Name:HAMED
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5900 4TH AVE UNIT 209
Mailing Address - Street 2:
Mailing Address - City:KENOSHA
Mailing Address - State:WI
Mailing Address - Zip Code:53140-4208
Mailing Address - Country:US
Mailing Address - Phone:314-201-8118
Mailing Address - Fax:
Practice Address - Street 1:4924 7TH AVE
Practice Address - Street 2:
Practice Address - City:KENOSHA
Practice Address - State:WI
Practice Address - Zip Code:53140-3349
Practice Address - Country:US
Practice Address - Phone:262-997-9573
Practice Address - Fax:262-997-9574
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-05
Last Update Date:2023-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2022034673183500000X
IL051305049183500000X
WI22049-40183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist