Provider Demographics
NPI:1801436803
Name:ABDEEN, THABITH MOHAMED (PHARMD)
Entity type:Individual
Prefix:
First Name:THABITH
Middle Name:MOHAMED
Last Name:ABDEEN
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2722 IOLA ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80238-3251
Mailing Address - Country:US
Mailing Address - Phone:714-474-9599
Mailing Address - Fax:
Practice Address - Street 1:1690 MEADE ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80204-1552
Practice Address - Country:US
Practice Address - Phone:303-264-6840
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-08
Last Update Date:2020-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPHA.0022411183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist