Edline Group Incorporated

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

3325 Issued in MA

Legal business name

EDLINE GROUP INCORPORATED

Practice address

393 Columbia Rd
Dorchester, MA 02125-2415

Phone

(617) 288-1616

Fax

(617) 506-6003

NPI assigned

Oct 20, 2006

Organization subpart

No

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

Authorized official

Name

Edward Obi

Title

Owner

Phone

(617) 288-1616

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• COMPTON DRUG Doing business as

Locations

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

{
    "created_epoch": "1161302400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1292457600000",
    "number": "1558443341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "393 COLUMBIA RD",
            "city": "DORCHESTER",
            "state": "MA",
            "postal_code": "021252415",
            "telephone_number": "617-288-1616",
            "fax_number": "617-506-6003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "393 COLUMBIA RD",
            "city": "DORCHESTER",
            "state": "MA",
            "postal_code": "021252415",
            "telephone_number": "617-288-1616",
            "fax_number": "617-506-6003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDLINE GROUP INCORPORATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-20",
        "last_updated": "2010-12-16",
        "status": "A",
        "authorized_official_last_name": "OBI",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "617-288-1616"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MA",
            "license": "3325",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "2227812",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0406350",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "COMPTON DRUG",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Samantha Rae Ecker, MS, CCC-SLP
• Frederica Davis Eder, OT
• Marie Jessy Edouard, RN
• Paula Minnette Edwards-Bagwell
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• Community/Retail Pharmacy in Dorchester, MA
• Providers in Dorchester, MA by specialty
• Community/Retail Pharmacy in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2010; 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.