Healthcare Provider Details

I. General information

NPI: 1033074141
Provider Name (Legal Business Name): EMMIE VICTORIA EDWARDS PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/20/2025
Last Update Date: 12/20/2025
Certification Date: 12/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

404 US HIGHWAY 27 BYP
BREMEN GA
30110-1950
US

IV. Provider business mailing address

PO BOX 13
WACO GA
30182-0013
US

V. Phone/Fax

Practice location:
  • Phone: 770-537-2131
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRPH035893
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: