Edyta Judge, PHARM.D.

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

23631 Issued in IA

Practice address

3140 SE 14TH St
Des Moines, IA 50320-1328

Phone

(515) 282-5295

NPI assigned

Dec 16, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Ms. Edyta Zareba Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Walgreen Co

  • Pharmacy
  • Des Moines, IA
  • NPI 1629083936
  NPD (past)
• Walgreen Co

  • Pharmacy
  • Longview, TX
  • NPI 1629956545
  NPD (past)

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

{
    "created_epoch": "1576454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576454400000",
    "number": "1659919116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1402 PRAIRIE VISTA CT",
            "city": "NORWALK",
            "state": "IA",
            "postal_code": "502118808",
            "telephone_number": "773-895-4610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3140 SE 14TH ST",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503201328",
            "telephone_number": "515-282-5295"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUDGE",
        "first_name": "EDYTA",
        "name_prefix": "Ms.",
        "credential": "PHARM.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-12-16",
        "last_updated": "2019-12-16",
        "certification_date": "2019-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "IA",
            "license": "23631",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EDYTA",
            "last_name": "ZAREBA",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Fatiah Joseph, MD
• Emma Malone Joss, LMHC
• Joy E Trueblood MD LLC
• Jubba Valley Outreach Inc
• Lisa Juckette
• Chase Ryan Juergensen, DO
• Mackenzie Ann Juergensen, TCADC
• Brett Juhl, PT
• Cynthia Jane Juhler, D.O.
• Joan Marie Julseth-Lewis, ARNP

• Community/Retail Pharmacy in Des Moines, IA
• Providers in Des Moines, IA by specialty
• Community/Retail Pharmacy in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2019; 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.