Healthcare Provider Details

I. General information

NPI: 1518935469
Provider Name (Legal Business Name): EDWARD CLIFFORD NORTON JR. R.PH
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 03/08/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

NAVAL HOSPITAL, CAMP PENDLETON BOX 555191 BLDG H100
CAMP PENDLETON CA
92055-5191
US

IV. Provider business mailing address

41 NORTON RD
FORT ANN NY
12827-5035
US

V. Phone/Fax

Practice location:
  • Phone: 760-725-1147
  • Fax:
Mailing address:
  • Phone: 951-894-6750
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number039538
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: