Active NPI
Scott A Edmundson, R.PH.
- Community/Retail Pharmacy
- Trafford, PA
National Provider Identifier
1477629665
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- License
- PP410571L
- Practice address
- 312 Cavitt Ave
Trafford, PA 15085-1065 - Phone
- (412) 372-5493
- Fax
- (412) 372-9543
- NPI assigned
- Nov 28, 2006
- Last updated
- Mar 23, 2009
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | RP041059L | PA | |
| Community/Retail Pharmacy | 3336C0003X | PP410571L | PA | Primary |
Addresses
Primary practice location
312 Cavitt Ave
Trafford, PA 15085-1065
Mailing address
312 Cavitt Ave
Trafford, PA 15085-1065
Phone (412) 372-5493
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3936549 | Other | NCPDP | |
| 0018255900001 | Medicaid | PA |
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 |
|---|---|---|---|
| RP041059L | PA | MD | Pharmacist |
| PP410571L | PA | MD | Community/Retail Pharmacy |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Scott a Edmundson | Community/Retail Pharmacy | Past | Accepting new patients |
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.
-
dba Trafford Family Pharmacy
- Community/Retail Pharmacy
- Trafford, PA
- NPI 1154497378
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164672000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1237766400000",
"number": "1477629665",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "312 CAVITT AVE",
"city": "TRAFFORD",
"state": "PA",
"postal_code": "150851065",
"telephone_number": "412-372-5493",
"fax_number": "412-372-5493"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "312 CAVITT AVE",
"city": "TRAFFORD",
"state": "PA",
"postal_code": "150851065",
"telephone_number": "412-372-5493",
"fax_number": "412-372-9543"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EDMUNDSON",
"first_name": "SCOTT",
"middle_name": "A",
"credential": "R.PH.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-11-28",
"last_updated": "2009-03-23",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "PA",
"license": "RP041059L",
"primary": false
},
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": "PA",
"license": "PP410571L",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NCPDP",
"identifier": "3936549",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0018255900001",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Trafford, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 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.