Med-Mart Pharmacy LLC
NPI 1386131050ActiveOrganization· Pharmacy· Fairmont, WV
Pharmacy in Fairmont, West Virginia, registered in NPPES in April 2018. The authorized official on file is Ibrahim Kaddourah, Owner/Pic.
Overview
| NPI | 1386131050 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Apr 18, 2018 |
| Last updated in NPPES | Dec 11, 2019 |
| Certified by provider | Dec 11, 2019 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Pharmacy Primary | 333600000X | SP0552522 | WV |
| Pharmacy, Community/Retail Pharmacy | 3336C0003X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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