Individual provider Active NPI

Ebony N Alfred

  • Pharmacy Technician
  • Beaumont, TX
National Provider Identifier
1821687294
Registry record updated Jan 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pharmacy TechnicianTaxonomy code 183700000X
Practice address
3590 College St
Beaumont, TX 77701-4614
Phone
(409) 813-8452
Fax
(409) 980-5883
NPI assigned
Jan 11, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy Technician 183700000X Primary

Addresses

Primary practice location

3590 College St
Beaumont, TX 77701-4614

Mailing address

3590 College St
Beaumont, TX 77701-4614
Phone (409) 813-8452

Other identifiers 1

IdentifierTypeStateIssuer
225954OtherTXPHARMACY TECHNICIAN LICENSE

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL NA

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

Practice roles

OrganizationSpecialtyStatusNew patients
H-E-B, LP PastSince Jan 17, 2021 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1610323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610323200000",
    "number": "1821687294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3590 COLLEGE ST",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777014614",
            "telephone_number": "409-813-8452",
            "fax_number": "409-980-5883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3590 COLLEGE ST",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777014614",
            "telephone_number": "409-813-8452",
            "fax_number": "409-980-5883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALFRED",
        "first_name": "EBONY",
        "middle_name": "N",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-11",
        "last_updated": "2021-01-11",
        "certification_date": "2021-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183700000X",
            "taxonomy_group": "",
            "desc": "Pharmacy Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACY TECHNICIAN LICENSE",
            "identifier": "225954",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "NA",
            "affiliation": "N",
            "address_1": "3590 College St",
            "city": "Beaumont",
            "state": "TX",
            "country_code": "US",
            "postal_code": "777014614",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Beaumont, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2021; 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.