Individual provider Active NPI

Curtis Jon Edwards, PHARM D

  • Pharmacist
  • Glendale, AZ
National Provider Identifier
1982999876
Registry record updated Jun 18, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
S017411 Issued in AZ
Practice address
10404 N 43Rd Ave
Glendale, AZ 85302-2019
Phone
(623) 931-5748
Fax
(623) 215-0602
NPI assigned
Jun 18, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 18, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X S017411 AZ Primary

Addresses

Primary practice location

10404 N 43Rd Ave
Glendale, AZ 85302-2019

Mailing address

10404 N 43Rd Ave
Glendale, AZ 85302-2019
Phone (623) 931-5748

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
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
S017411AZMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1308355200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1308355200000",
    "number": "1982999876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10404 N 43RD AVE",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853022019",
            "telephone_number": "623-931-5748",
            "fax_number": "623-215-0602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10404 N 43RD AVE",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853022019",
            "telephone_number": "623-931-5748",
            "fax_number": "623-215-0602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "CURTIS",
        "middle_name": "JON",
        "credential": "PHARM D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-06-18",
        "last_updated": "2011-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "AZ",
            "license": "S017411",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2011; 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.