1275748402 NPI number — MR. MOHAMMED AMIR MASOOD PHARMD.

Table of content: MR. MOHAMMED AMIR MASOOD PHARMD. (NPI 1275748402)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1275748402 NPI number — MR. MOHAMMED AMIR MASOOD PHARMD.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MASOOD
Provider First Name:
MOHAMMED
Provider Middle Name:
AMIR
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
PHARMD.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1275748402
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/25/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3030 CULLERTON ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FRANKLIN PARK
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
60131-2205
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
847-916-4575
Provider Business Mailing Address Fax Number:
847-916-4114

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
OSCO PHARMACY
Provider Second Line Business Practice Location Address:
7530 SOUTH CASS AVE.
Provider Business Practice Location Address City Name:
DARIEN
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60561
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
630-852-0070
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/11/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 183500000X , with the licence number:  051-287295 , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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