Active NPI
Edna V Sandoval, RPH
- Pharmacist
- Albuquerque, NM
National Provider Identifier
1598074585
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 4883
- Practice address
- 2709 Pan Am Fwy NE Ste G
Albuquerque, NM 87107-1650 - Phone
- (505) 344-4739
- NPI assigned
- Sep 24, 2010
- Sex
- Female
- Sole proprietor
- Yes
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 | 4883 | NM | Primary |
Addresses
Primary practice location
2709 Pan Am Fwy NE Ste G
Albuquerque, NM 87107-1650
Mailing address
PO Box 16084
Santa Fe, NM 87592-6084
Phone (505) 471-3021
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4883 | Other | NM | PHARMACY LICENSE--NM #4883 |
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 |
|---|---|---|---|
| 4883 | NM | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1285286400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1285286400000",
"number": "1598074585",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 16084",
"city": "SANTA FE",
"state": "NM",
"postal_code": "875926084",
"telephone_number": "505-471-3021"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2709 PAN AM FWY NE STE G",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871071650",
"telephone_number": "505-344-4739"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SANDOVAL",
"first_name": "EDNA",
"middle_name": "V",
"credential": "RPH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-09-24",
"last_updated": "2010-09-24",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NM",
"license": "4883",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHARMACY LICENSE--NM #4883",
"identifier": "4883",
"state": "NM"
}
],
"endpoints": [],
"other_names": []
}Other providers in Albuquerque, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 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.