Active NPI
David Eden, PHARMACIST
- Pharmacist
- Mount Vernon, MO
National Provider Identifier
1134526072
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 040017
- Practice address
- 606 E Mount Vernon Blvd
Mount Vernon, MO 65712-9100 - Phone
- (417) 466-2000
- Fax
- (417) 466-2028
- NPI assigned
- Nov 20, 2014
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 040017 | MO | Primary |
Addresses
Primary practice location
606 E Mount Vernon Blvd
Mount Vernon, MO 65712-9100
Mailing address
606 E Mount Vernon Blvd
PO Box 68
Mount Vernon, MO 65712-9100
Phone (417) 466-2000
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 040017 | MO | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1416441600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1416441600000",
"number": "1134526072",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "606 E MOUNT VERNON BLVD",
"address_2": "PO BOX 68",
"city": "MOUNT VERNON",
"state": "MO",
"postal_code": "657129100",
"telephone_number": "417-466-2000",
"fax_number": "417-466-2028"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "606 E MOUNT VERNON BLVD",
"city": "MOUNT VERNON",
"state": "MO",
"postal_code": "657129100",
"telephone_number": "417-466-2000",
"fax_number": "417-466-2028"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EDEN",
"first_name": "DAVID",
"credential": "PHARMACIST",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-11-20",
"last_updated": "2014-11-20",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MO",
"license": "040017",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mount Vernon, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.