Provider Demographics
NPI:1588544795
Name:JUBOORI, MOHAMED (PHARMD)
Entity type:Individual
Prefix:
First Name:MOHAMED
Middle Name:
Last Name:JUBOORI
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 1:830 BLYTHE AVE
Mailing Address - Street 2:
Mailing Address - City:DREXEL HILL
Mailing Address - State:PA
Mailing Address - Zip Code:19026-4410
Mailing Address - Country:US
Mailing Address - Phone:410-935-7656
Mailing Address - Fax:
Practice Address - Street 1:830 BLYTHE AVE
Practice Address - Street 2:
Practice Address - City:DREXEL HILL
Practice Address - State:PA
Practice Address - Zip Code:19026-4410
Practice Address - Country:US
Practice Address - Phone:410-935-7656
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-08
Last Update Date:2025-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP451778183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist