Edison Medical Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

054009337 Issued in IL

Legal business name

EDISON MEDICAL PHARMACY INC

Practice address

4240 W Madison St
Chicago, IL 60624-2288

Phone

(773) 533-2535

Fax

(773) 533-2535

NPI assigned

Dec 4, 2006

Organization subpart

No

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

Authorized official

Name

Pravinchandra Shah, RPH

Title

Rphowner

Phone

(773) 533-2535

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• EDISON MEDICAL PHARMACY Doing business as

Locations

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

{
    "created_epoch": "1165190400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1426204800000",
    "number": "1821166067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4240 W MADISON ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606242288",
            "telephone_number": "773-533-2535",
            "fax_number": "773-533-2535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4240 W MADISON ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606242288",
            "telephone_number": "773-533-2535",
            "fax_number": "773-533-2535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDISON MEDICAL PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-04",
        "last_updated": "2015-03-13",
        "status": "A",
        "authorized_official_last_name": "SHAH",
        "authorized_official_first_name": "PRAVINCHANDRA",
        "authorized_official_title_or_position": "RPHOWNER",
        "authorized_official_telephone_number": "773-533-2535",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "IL",
            "license": "054009337",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2020547",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "EDISON MEDICAL PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Edgewater Rehabilitation Center
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• Christopher Kirkwood Edginton, D.C.
• James F. Edgren, LCPC
• Edison Logistics
• Edison Park Smiles,LTD
• Nicole D Edison
• Edith Khurana MD SC
• Ann Taylor Edlund
• Natasha Ilyana Edman, MD, PHD

• Community/Retail Pharmacy in Chicago, IL
• Providers in Chicago, IL by specialty
• Community/Retail Pharmacy in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2015; 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.