Individual provider Active NPI

Edward Jude Stein, PHARMD, MPH

  • Pharmacist
  • Phoenix, AZ
National Provider Identifier
1770064107
Registry record updated Aug 23, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
10663 Issued in NE
Practice address
Two Renaissance Square, 40 N Central Ave
Suite 780, IHS Clinical Support Center
Phoenix, AZ 85004
Phone
(602) 364-7777
Fax
(602) 364-7788
NPI assigned
Aug 23, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 10663 NE Primary

Addresses

Primary practice location

Two Renaissance Square, 40 N Central Ave
Suite 780, IHS Clinical Support Center
Phoenix, AZ 85004

Mailing address

12929 N 72ND Ave
Peoria, AZ 85381-9583
Phone (623) 910-1074

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
10663NEMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1534982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534982400000",
    "number": "1770064107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12929 N 72ND AVE",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853819583",
            "telephone_number": "623-910-1074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "TWO RENAISSANCE SQUARE, 40 N CENTRAL AVE",
            "address_2": "SUITE 780, IHS CLINICAL SUPPORT CENTER",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "85004",
            "telephone_number": "602-364-7777",
            "fax_number": "602-364-7788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEIN",
        "first_name": "EDWARD",
        "middle_name": "JUDE",
        "name_prefix": "Dr.",
        "credential": "PHARMD, MPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-08-23",
        "last_updated": "2018-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NE",
            "license": "10663",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2018; 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.