Edward Kobialka Jr., RPH

Primary specialty

Ambulatory Care PharmacistTaxonomy code 1835P2201X

License

PCT0006502 Issued in CT

Practice address

Highway 163
Building Ka 2010
Kayenta, AZ 86033

Phone

(928) 697-4165

NPI assigned

Oct 9, 2015

Last updated

Oct 9, 2015By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Pharmacist

State licenses

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

{
    "created_epoch": "1444348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444348800000",
    "number": "1861863342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 462",
            "city": "KAYENTA",
            "state": "AZ",
            "postal_code": "860330462",
            "telephone_number": "360-431-3636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "HIGHWAY 163",
            "address_2": "BUILDING KA 2010",
            "city": "KAYENTA",
            "state": "AZ",
            "postal_code": "86033",
            "telephone_number": "928-697-4165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOBIALKA",
        "first_name": "EDWARD",
        "name_suffix": "Jr.",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-10-09",
        "last_updated": "2015-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P2201X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Ambulatory Care",
            "state": "CT",
            "license": "PCT0006502",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lorraine D Kelwood, FAMILY NURSE PRACTIT
• Arnold Ketchum, PA-C
• Kwang Kim, RD
• Garrettson Michael King, CNA
• Jeremy King
• Christina D Krutsky, CNM
• Steven Labrozzi, RPH PA-C
• Connie Jo Larkin, APRN
• Rebecca C Larsen, AU.D.
• Brenda Lee, LMSW

• Ambulatory Care Pharmacist in Kayenta, AZ
• Providers in Kayenta, AZ by specialty
• Ambulatory Care Pharmacist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 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.