Provider Demographics
NPI:1700155413
Name:MOLAVI, HAMID REZA (PHARM-D)
Entity Type:Individual
Prefix:DR
First Name:HAMID
Middle Name:REZA
Last Name:MOLAVI
Suffix:
Gender:M
Credentials:PHARM-D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:725 E 97TH ST
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64131-3244
Mailing Address - Country:US
Mailing Address - Phone:816-941-2234
Mailing Address - Fax:
Practice Address - Street 1:2261 S STERLING AVE
Practice Address - Street 2:
Practice Address - City:INDEPENDENCE
Practice Address - State:MO
Practice Address - Zip Code:64052-3668
Practice Address - Country:US
Practice Address - Phone:816-833-5840
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-12-26
Last Update Date:2011-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2007035413183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist