Individual provider Active NPI

Edna Evangeline Sobania, RPH

  • Pharmacist
  • Baxter, MN
National Provider Identifier
1821741786
Registry record updated Feb 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
115559 Issued in MN
Practice address
4426 Cedar Scenic Rd
Baxter, MN 56425-3003
Phone
(218) 838-0965
NPI assigned
Feb 1, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 115559 MN Primary

Addresses

Primary practice location

4426 Cedar Scenic Rd
Baxter, MN 56425-3003

Mailing address

4426 Cedar Scenic Rd
Baxter, MN 56425-3003

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
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
115559MNMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1643673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643673600000",
    "number": "1821741786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4426 CEDAR SCENIC RD",
            "city": "BAXTER",
            "state": "MN",
            "postal_code": "564253003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4426 CEDAR SCENIC RD",
            "city": "BAXTER",
            "state": "MN",
            "postal_code": "564253003",
            "telephone_number": "218-838-0965"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOBANIA",
        "first_name": "EDNA",
        "middle_name": "EVANGELINE",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-01",
        "last_updated": "2022-02-01",
        "certification_date": "2022-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MN",
            "license": "115559",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baxter, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2022; 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.