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General NPI Number Information
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NPI Number | 1629497284
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Entity Type | Organization
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Legal Business Name | EDINBURGH ENTERPRISES LLC
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Dates
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Enumeration Date | 04/10/2014
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Last Update Date | 04/10/2014
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Provider Practice Location Address
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Address Line | 11780 W 118TH TER 118
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City | OVERLAND PARK
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State | KS
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Zip | 66210-2073
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Country | US
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Telephone | 949-599-4005
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Fax |
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Provider Business Mailing Address
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Address Line | 11780 W 118TH TER 118
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City | OVERLAND PARK
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State | KS
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Zip | 66210-2073
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | DR. ANDREAS GOMAROONI
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Credential | PHARMD
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Telephone | 949-599-4005
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1835P1200X
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Taxonomy Name | Pharmacotherapy Pharmacist
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License Number | 1-15498
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License Number State | KS
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