Provider Demographics
NPI:1396324786
Name:ALMUSLIM, MUJTBA (PHARMD)
Entity type:Individual
Prefix:
First Name:MUJTBA
Middle Name:
Last Name:ALMUSLIM
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 1:220 S 38TH ST
Mailing Address - Street 2:
Mailing Address - City:COUNCIL BLUFFS
Mailing Address - State:IA
Mailing Address - Zip Code:51501-3464
Mailing Address - Country:US
Mailing Address - Phone:402-305-0346
Mailing Address - Fax:
Practice Address - Street 1:2109 TOWNE CENTRE DR
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:NE
Practice Address - Zip Code:68123-6404
Practice Address - Country:US
Practice Address - Phone:402-686-2043
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-05
Last Update Date:2021-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE16881183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist