Active NPI
Roman Estrada
- Pharmacist
- Prescott, AZ
National Provider Identifier
1396072302
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 10878
- Practice address
- 3911 E State Route 69
Prescott, AZ 86301-6717 - Phone
- (928) 541-2218
- Fax
- (928) 541-2257
- NPI assigned
- Nov 11, 2009
- 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 | 10878 | AZ | Primary |
Addresses
Primary practice location
3911 E State Route 69
Prescott, AZ 86301-6717
Mailing address
3911 E State Route 69
Prescott, AZ 86301-6717
Phone (928) 541-2218
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10878 | AZ | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1257897600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1257897600000",
"number": "1396072302",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3911 E STATE ROUTE 69",
"city": "PRESCOTT",
"state": "AZ",
"postal_code": "863016717",
"telephone_number": "928-541-2218",
"fax_number": "928-541-2257"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3911 E STATE ROUTE 69",
"city": "PRESCOTT",
"state": "AZ",
"postal_code": "863016717",
"telephone_number": "928-541-2218",
"fax_number": "928-541-2257"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ESTRADA",
"first_name": "ROMAN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-11-11",
"last_updated": "2009-11-11",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "AZ",
"license": "10878",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Prescott, AZ
- Rune Espenhein, PHARMD
- Allan V. Espinosa Morazan, M.D.
- Kelee G Esquivel, PHARMD
- Yolanda Esquivel, OTR
- Essential Care Family Medicine, P.C.
- Esmeralda Martinez Etudor, REGISTERED NURSE
- Utibe Joshua Etudor, NP
- Evolving Healthcare PLC
- Exceptional Health Care Prescott LLC
- Exceptional Physicians Group Prescott Hospital PLLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.