Organization Active NPI

Edna Pharmacy LLC

  • Community/Retail Pharmacy
  • Edna, TX
National Provider Identifier
1780149476
Registry record updated Nov 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
EDNA PHARMACY LLC
Practice address
604 N Wells St
Edna, TX 77957-2719
Phone
(361) 308-5039
NPI assigned
Feb 6, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2025

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

Authorized official

Name
Mr. Ike Ike, DR
Title
Manager
Phone
(361) 308-5039

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X Primary

Addresses

Primary practice location

604 N Wells St
Edna, TX 77957-2719

Mailing address

604 N Wells St
Edna, TX 77957-2719
Phone (361) 308-5039

Other identifiers 1

IdentifierTypeStateIssuer
150002MedicaidTX

Other names 1

  • Edna Pharmacy Doing business as

National Provider Directory

National Provider Directory

Locations

604 N Wells St
Edna, TX 77957
Phone (361) 308-5039

6250 Westpark Dr
Ste 210
Houston, TX 77057
Phone (713) 781-9668

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1549411200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1763683200000",
    "number": "1780149476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "604 N WELLS ST",
            "city": "EDNA",
            "state": "TX",
            "postal_code": "779572719",
            "telephone_number": "361-308-5039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "604 N WELLS ST",
            "city": "EDNA",
            "state": "TX",
            "postal_code": "779572719",
            "telephone_number": "361-308-5039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDNA PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-02-06",
        "last_updated": "2025-11-21",
        "certification_date": "2025-11-21",
        "status": "A",
        "authorized_official_last_name": "IKE",
        "authorized_official_first_name": "IKE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "361-308-5039",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DR"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "150002",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Edna Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Edna Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Edna, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2025; 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.