Active NPI
Robert Ward Kidston Sr., RPH
- Pharmacist
- Boardman, OH
National Provider Identifier
1891360327
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 03110945
- Practice address
- 8401 Market St
Boardman, OH 44512-6725 - Phone
- (330) 729-4580
- NPI assigned
- May 26, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 03110945 | OH | Primary |
Addresses
Primary practice location
8401 Market St
Boardman, OH 44512-6725
Mailing address
8645 Van Dr
Poland, OH 44514-2954
Phone (330) 565-5246
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
| License | State | Type | Specialty |
|---|---|---|---|
| 03110945 | OH | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1621987200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1621987200000",
"number": "1891360327",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8645 VAN DR",
"city": "POLAND",
"state": "OH",
"postal_code": "445142954",
"telephone_number": "330-565-5246"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8401 MARKET ST",
"city": "BOARDMAN",
"state": "OH",
"postal_code": "445126725",
"telephone_number": "330-729-4580"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIDSTON",
"first_name": "ROBERT",
"middle_name": "WARD",
"name_prefix": "Mr.",
"name_suffix": "Sr.",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-05-26",
"last_updated": "2021-05-26",
"certification_date": "2021-05-26",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "OH",
"license": "03110945",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Boardman, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 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.