Provider Demographics
NPI:1952615676
Name:AHMED, FARHAT NONE (PHARMACIST)
Entity Type:Individual
Prefix:MRS
First Name:FARHAT
Middle Name:NONE
Last Name:AHMED
Suffix:
Gender:F
Credentials:PHARMACIST
Other - Prefix:MRS
Other - First Name:FARHAT
Other - Middle Name:NONE
Other - Last Name:AHMED
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHARMACIST
Mailing Address - Street 1:585 S RIVERSIDE AVE
Mailing Address - Street 2:
Mailing Address - City:RIALTO
Mailing Address - State:CA
Mailing Address - Zip Code:92376-7071
Mailing Address - Country:US
Mailing Address - Phone:909-820-7474
Mailing Address - Fax:909-820-2940
Practice Address - Street 1:585 S RIVERSIDE AVE
Practice Address - Street 2:
Practice Address - City:RIALTO
Practice Address - State:CA
Practice Address - Zip Code:92376-7071
Practice Address - Country:US
Practice Address - Phone:909-820-7474
Practice Address - Fax:909-820-2940
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-05
Last Update Date:2010-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA40107183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist