Active NPI
Robert Gerald Edgin, RPH
- Pharmacist
- New Boston, TX
National Provider Identifier
1437252632
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 18656
- Practice address
- 10 Main Dr
Red River Commerce Park
New Boston, TX 75570-9534 - Phone
- (800) 503-7604
- Fax
- (866) 300-9797
- NPI assigned
- Sep 6, 2006
- Last updated
- Jul 8, 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 | 18656 | TX | Primary |
Addresses
Primary practice location
10 Main Dr
Red River Commerce Park
New Boston, TX 75570-9534
Mailing address
563 Central Rd
Horatio, AR 71842-8847
Phone (870) 832-5816
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 |
|---|---|---|---|
| 18656 | TX | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1157500800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1437252632",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "563 CENTRAL RD",
"city": "HORATIO",
"state": "AR",
"postal_code": "718428847",
"telephone_number": "870-832-5816"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10 MAIN DR",
"address_2": "RED RIVER COMMERCE PARK",
"city": "NEW BOSTON",
"state": "TX",
"postal_code": "755709534",
"telephone_number": "800-503-7604",
"fax_number": "866-300-9797"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EDGIN",
"first_name": "ROBERT",
"middle_name": "GERALD",
"name_prefix": "Mr.",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-06",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "TX",
"license": "18656",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in New Boston, TX
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.