Individual provider Active NPI

Ephrem Degefu, R.PH.

  • Pharmacist
  • West Palm Beach, FL
National Provider Identifier
1396802468
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PS0026179 Issued in FL
Practice address
2215 N Military TRL Ste L
West Palm Beach, FL 33409-2901
Phone
(561) 683-1095
Fax
(561) 683-0591
NPI assigned
Jan 1, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PS0026179 FL Primary

Addresses

Primary practice location

2215 N Military TRL Ste L
West Palm Beach, FL 33409-2901

Mailing address

740 Bocce CT
Palm Beach Gardens, FL 33410-1532
Phone (561) 312-1847

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

LicenseStateTypeSpecialty
PS0026179FLMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1167609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1396802468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "740 BOCCE CT",
            "city": "PALM BEACH GARDENS",
            "state": "FL",
            "postal_code": "334101532",
            "telephone_number": "561-312-1847"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2215 N MILITARY TRL STE L",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334092901",
            "telephone_number": "561-683-1095",
            "fax_number": "561-683-0591"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEGEFU",
        "first_name": "EPHREM",
        "name_prefix": "Mr.",
        "credential": "R.PH.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS0026179",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Palm Beach, FL

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.

Verify at the official NPI Registry.