Robert S Medina, RPH

Primary specialty

PharmacistTaxonomy code 183500000X

License

RP6576 Issued in NM

Practice address

535 Central Ave
Los Alamos, NM 87544-3202

Phone

(505) 662-4778

NPI assigned

Sep 27, 2010

Last updated

Sep 27, 2010By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Pharmacist

State licenses

Practice roles

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.

• Smith's Food & Drug Centers Inc

  dba Smith's Pharmacy #303

  • Community/Retail Pharmacy
  • Henderson, NV
  • NPI 1881585248
  NPD (past)

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

{
    "created_epoch": "1285545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1285545600000",
    "number": "1114236056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "182 BLUE SPRUCE DR",
            "city": "JEMEZ SPRINGS",
            "state": "NM",
            "postal_code": "870259069",
            "telephone_number": "505-662-4778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "535 CENTRAL AVE",
            "city": "LOS ALAMOS",
            "state": "NM",
            "postal_code": "875443202",
            "telephone_number": "505-662-4778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDINA",
        "first_name": "ROBERT",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-09-27",
        "last_updated": "2010-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NM",
            "license": "RP6576",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEW MEXICO PHARMACIST LICENSE",
            "identifier": "RP006576",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Victoria McFarland
• Megan McGuiness, MSN, APRN, PMNHP-BC
• Merry McIntyre, DC
• Erik McMurray
• Medical Associates of Northern New Mexico
• Josie Ann Medrano, DOCTOR OF PHARMACY
• Laura K Merrigan, NP-C
• David A Mesibov, MD
• Rachel Meyer, DDS
• Elizabeth Abagail Midyette, PA-C

• Pharmacist in Los Alamos, NM
• Providers in Los Alamos, NM by specialty
• Pharmacist in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2010; 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.