Active NPI
Edward Horace Robinson IV, PHARMD, RPH
- Pharmacist
- Jacksonville, FL
National Provider Identifier
1396342770
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PS61673
- Practice address
- 12387 Yellow Bluff Rd
Jacksonville, FL 32226-2025 - Phone
- (904) 751-2744
- NPI assigned
- Oct 8, 2020
- Last updated
- Oct 8, 2020
- Sex
- Male
- Sole proprietor
- Yes
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 | PS61673 | FL | Primary |
Addresses
Primary practice location
12387 Yellow Bluff Rd
Jacksonville, FL 32226-2025
Mailing address
55244 Yellow Jacket Dr
Callahan, FL 32011-8533
Phone (904) 879-5242
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, Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PS61673 | FL | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Current | Accepting new patients |
Locations
12387 Yellow Bluff Rd
Jacksonville, FL 32226
Phone (904) 751-2744
Organizations & group practices 1
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": "1602115200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1602115200000",
"number": "1396342770",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "55244 YELLOW JACKET DR",
"city": "CALLAHAN",
"state": "FL",
"postal_code": "320118533",
"telephone_number": "904-879-5242"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12387 YELLOW BLUFF RD",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322262025",
"telephone_number": "904-751-2744"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROBINSON",
"first_name": "EDWARD",
"middle_name": "HORACE",
"name_prefix": "Dr.",
"name_suffix": "IV",
"credential": "PHARMD, RPH",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-10-08",
"last_updated": "2020-10-08",
"certification_date": "2020-10-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "FL",
"license": "PS61673",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Jacksonville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 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.