Provider Demographics
NPI:1427878834
Name:IBRAHIM, ALI (PHARMD)
Entity type:Individual
Prefix:
First Name:ALI
Middle Name:
Last Name:IBRAHIM
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 1:3127 N HILL RD APT 204
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68504-4730
Mailing Address - Country:US
Mailing Address - Phone:619-635-8946
Mailing Address - Fax:
Practice Address - Street 1:3127 N HILL RD APT 204
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68504-4730
Practice Address - Country:US
Practice Address - Phone:619-635-8946
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-11
Last Update Date:2024-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE18425183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist