Individual provider Active NPI

Edwin F Gonzales, RPH

  • Pharmacist
  • Albuquerque, NM
National Provider Identifier
1215243738
Registry record updated Aug 20, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
3486 Issued in NM
Practice address
5850 Eubank Blvd NE
Albuquerque, NM 87111-6132
Phone
(505) 299-7621
Fax
(505) 296-8225
NPI assigned
Aug 20, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 20, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 3486 NM Primary

Addresses

Primary practice location

5850 Eubank Blvd NE
Albuquerque, NM 87111-6132

Mailing address

5850 Eubank Blvd NE
Albuquerque, NM 87111-6132
Phone (505) 299-7621

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
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
3486NMMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1282262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1282262400000",
    "number": "1215243738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5850 EUBANK BLVD NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871116132",
            "telephone_number": "505-299-7621",
            "fax_number": "505-296-8225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5850 EUBANK BLVD NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871116132",
            "telephone_number": "505-299-7621",
            "fax_number": "505-296-8225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALES",
        "first_name": "EDWIN",
        "middle_name": "F",
        "name_prefix": "Mr.",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-08-20",
        "last_updated": "2010-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NM",
            "license": "3486",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 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.