Active NPI
Mary Edelman, PHARMD
- Pharmacist
- Philadelphia, PA
National Provider Identifier
1245826841
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RP443777
- Practice address
- 1117 Walnut St
Philadelphia, PA 19107-4965 - Phone
- (215) 627-2143
- Fax
- (215) 627-8943
- NPI assigned
- Dec 17, 2020
- Sex
- Female
- 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 | RP443777 | PA | Primary |
Addresses
Primary practice location
1117 Walnut St
Philadelphia, PA 19107-4965
Mailing address
932 B Ellsworth Street
Philadelphia, PA 19147
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
| License | State | Type | Specialty |
|---|---|---|---|
| RP443777 | PA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Procare Pharmacy, L.L.C. | Current | Accepting new patients | |
| Procare Pharmacy, LLC. | Past | Accepting new patients |
Organizations & group practices 2
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": "1608163200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1608163200000",
"number": "1245826841",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "932 B ELLSWORTH STREET",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "19147"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1117 WALNUT ST",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191074965",
"telephone_number": "215-627-2143",
"fax_number": "215-627-8943"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EDELMAN",
"first_name": "MARY",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-12-17",
"last_updated": "2020-12-17",
"certification_date": "2020-12-15",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "PA",
"license": "RP443777",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.