Provider Demographics
NPI:1477279800
Name:OMERHODZIC, EDINA (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:EDINA
Middle Name:
Last Name:OMERHODZIC
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:EDINA
Other - Middle Name:
Other - Last Name:BEGIC
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2321 NE LITTLE BEAVER DR
Mailing Address - Street 2:
Mailing Address - City:GRIMES
Mailing Address - State:IA
Mailing Address - Zip Code:50111-4510
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2321 NE LITTLE BEAVER DR
Practice Address - Street 2:
Practice Address - City:GRIMES
Practice Address - State:IA
Practice Address - Zip Code:50111-4510
Practice Address - Country:US
Practice Address - Phone:515-371-2877
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-18
Last Update Date:2022-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA24612183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist