Individual provider Active NPI

Eduardo Gomez, PHARMD

  • Pharmacist
  • Bullhead City, AZ
National Provider Identifier
1528495405
Registry record updated Jan 27, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
S020186 Issued in AZ
Practice address
2840 Highway 95
Bullhead City, AZ 86442-7792
Phone
(928) 758-3447
Fax
(928) 758-3496
NPI assigned
Oct 9, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X S020186 AZ Primary

Addresses

Primary practice location

2840 Highway 95
Bullhead City, AZ 86442-7792

Mailing address

2840 Highway 95
Bullhead City, AZ 86442-7792
Phone (928) 758-3447

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

State licenses

LicenseStateTypeSpecialty
S020186AZMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1381276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1390780800000",
    "number": "1528495405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2840 HIGHWAY 95",
            "city": "BULLHEAD CITY",
            "state": "AZ",
            "postal_code": "864427792",
            "telephone_number": "928-758-3447",
            "fax_number": "928-758-3496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2840 HIGHWAY 95",
            "city": "BULLHEAD CITY",
            "state": "AZ",
            "postal_code": "864427792",
            "telephone_number": "928-758-3447",
            "fax_number": "928-758-3496"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOMEZ",
        "first_name": "EDUARDO",
        "name_prefix": "Mr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-10-09",
        "last_updated": "2014-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "AZ",
            "license": "S020186",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bullhead City, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2014; 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.