Individual provider Active NPI

Edward Peter Cassidy Jr., PHARMD

  • Pharmacist
  • Columbus Grove, OH
National Provider Identifier
1114052982
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
03126052 Issued in OH
Practice address
114 N High St
Columbus Grove, OH 45830
Phone
(419) 659-2366
Fax
(419) 659-2346
NPI assigned
Feb 22, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 03126052 OH Primary

Addresses

Primary practice location

114 N High St
Columbus Grove, OH 45830

Mailing address

PO Box 126
Columbus Grove, OH 45830
Phone (419) 659-2366

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
03126052OHMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Hawkeys Inc of Columbus Grove Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1172102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1114052982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 126",
            "city": "COLUMBUS GROVE",
            "state": "OH",
            "postal_code": "45830",
            "telephone_number": "419-659-2366",
            "fax_number": "419-659-2346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 N HIGH ST",
            "city": "COLUMBUS GROVE",
            "state": "OH",
            "postal_code": "45830",
            "telephone_number": "419-659-2366",
            "fax_number": "419-659-2346"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASSIDY",
        "first_name": "EDWARD",
        "middle_name": "PETER",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "OH",
            "license": "03126052",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus Grove, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.