Active NPI
Peter Ediagbonya, RPH
- Pharmacist
- Jacksonville, FL
National Provider Identifier
1306980891
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PS30313
- Practice address
- 1012 Edgewood Ave N
Jacksonville, FL 32254-2324 - Phone
- (904) 695-2727
- Fax
- (904) 783-8151
- NPI assigned
- Feb 16, 2007
- 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 | PS30313 | FL | Primary |
Addresses
Primary practice location
1012 Edgewood Ave N
Jacksonville, FL 32254-2324
Mailing address
1012 Edgewood Ave N
Jacksonville, FL 32254-2324
Phone (904) 695-2727
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
| License | State | Type | Specialty |
|---|---|---|---|
| PS30313 | FL | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171584000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1306980891",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1012 EDGEWOOD AVE N",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322542324",
"telephone_number": "904-695-2727",
"fax_number": "904-783-8151"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1012 EDGEWOOD AVE N",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322542324",
"telephone_number": "904-695-2727",
"fax_number": "904-783-8151"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EDIAGBONYA",
"first_name": "PETER",
"name_prefix": "Mr.",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-02-16",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "FL",
"license": "PS30313",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jacksonville, FL
- Krystal Kay Edgar, CRNA
- Robin L Edge, SLP-CCC
- Edgewood Maximus Operations LLC (Edgewood Nursing and Rehabilitation Center)
- Edgewood Nursing Center Inc (EdgeWood Nursing Center)
- Jonathon Curtis Edgy, MD
- Stefanie Ann Edinger, PHARMD
- Teresa A. Edison, ARNP
- Michelle L Edmonds, M.D.
- Derenda Denise Edmondson
- Eduardo a. Sanchez, M.D., P.a.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.