Provider Demographics
NPI:1053291674
Name:MOHAMED, SUMEIA M I
Entity type:Individual
Prefix:
First Name:SUMEIA
Middle Name:M
Last Name:MOHAMED
Suffix:I
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2984 V ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:OR
Mailing Address - Zip Code:97477-7949
Mailing Address - Country:US
Mailing Address - Phone:541-360-9297
Mailing Address - Fax:
Practice Address - Street 1:1675 COBURG RD
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-4854
Practice Address - Country:US
Practice Address - Phone:541-344-0015
Practice Address - Fax:541-344-4946
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-04
Last Update Date:2025-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORRPH-0020675183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist