Individual provider Active NPI

Irina Yermolovich, PHARM D

  • Pharmacist
  • Goodyear, AZ
National Provider Identifier
1205239381
Registry record updated Oct 2, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
S020926 Issued in AZ
Practice address
1100 N Estrella Pkwy
Goodyear, AZ 85338-2808
Phone
(623) 925-9883
NPI assigned
Oct 2, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X S020926 AZ Primary

Addresses

Primary practice location

1100 N Estrella Pkwy
Goodyear, AZ 85338-2808

Mailing address

1100 N Estrella Pkwy
Goodyear, AZ 85338-2808
Phone (623) 925-9883

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
S020926AZMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1412208000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412208000000",
    "number": "1205239381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 N ESTRELLA PKWY",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "853382808",
            "telephone_number": "623-925-9883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 N ESTRELLA PKWY",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "853382808",
            "telephone_number": "623-925-9883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YERMOLOVICH",
        "first_name": "IRINA",
        "credential": "PHARM D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-02",
        "last_updated": "2014-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "AZ",
            "license": "S020926",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Goodyear, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 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.

Verify at the official NPI Registry.