Provider Demographics
NPI:1831082015
Name:SUFI, ABDULLAH NADEEM (RPH)
Entity type:Individual
Prefix:
First Name:ABDULLAH
Middle Name:NADEEM
Last Name:SUFI
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17510 ORRVILLE RD
Mailing Address - Street 2:
Mailing Address - City:WILDWOOD
Mailing Address - State:MO
Mailing Address - Zip Code:63005-6308
Mailing Address - Country:US
Mailing Address - Phone:314-276-2701
Mailing Address - Fax:
Practice Address - Street 1:2290 W OSAGE ST
Practice Address - Street 2:
Practice Address - City:PACIFIC
Practice Address - State:MO
Practice Address - Zip Code:63069-1131
Practice Address - Country:US
Practice Address - Phone:636-257-9777
Practice Address - Fax:636-257-9774
Is Sole Proprietor?:No
Enumeration Date:2025-05-29
Last Update Date:2025-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2025011787183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist