Healthcare Provider Details

I. General information

NPI: 1215142104
Provider Name (Legal Business Name): EDWARD W WRIGHT PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/13/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

220 N MAIN ST
TRENTON FL
32693-3438
US

IV. Provider business mailing address

9227 NW 25TH LN
GAINESVILLE FL
32606-9150
US

V. Phone/Fax

Practice location:
  • Phone: 352-463-2240
  • Fax: 352-463-1645
Mailing address:
  • Phone: 352-331-7432
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPS0034390
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: