Augustina O Egwim, ETC

Primary specialty

PharmacistTaxonomy code 183500000X

License

123638 Issued in MN

Practice address

1401 Maryland Ave E
Saint Paul, MN 55106-2850

Phone

(651) 774-3011

NPI assigned

Aug 14, 2020

Sex

Female

Sole proprietor

No

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

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 and National Provider Directory roles.

• Walgreen Co

  • Pharmacy
  • Saint Paul, MN
  • NPI 1235144544
  NPD (past)
• Walgreen Co

  • Pharmacy
  • Longview, TX
  • NPI 1629956545
  NPD (past)

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

{
    "created_epoch": "1597363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597363200000",
    "number": "1285245993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 MARYLAND AVE E",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551062850",
            "telephone_number": "651-774-3011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 MARYLAND AVE E",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551062850",
            "telephone_number": "651-774-3011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EGWIM",
        "first_name": "AUGUSTINA",
        "middle_name": "O",
        "name_prefix": "Dr.",
        "credential": "ETC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-14",
        "last_updated": "2020-08-14",
        "certification_date": "2020-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MN",
            "license": "123638",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACIST LICENSE",
            "identifier": "123638",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amber Nicole Egdorf, MA, LADC, LPCC
• Ryan James Egeberg, CRNA
• Eli Eggen, PHARMD
• Mary Kathleen Eggink, NP
• Kathryn Eggleston, M.D.
• Amy Egyhazi
• Stacey M Ehlers-Millett, R.N., C.N.P.
• Amanda Louise Ehret, PA-C
• Richard Charles Ehrmanntraut, D.D.S.
• Gregg A Eichenfield, PH.D.

• Pharmacist in Saint Paul, MN
• Providers in Saint Paul, MN by specialty
• Pharmacist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 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.

Verify at the official NPI Registry.