Healthcare Provider Details
I. General information
NPI: 1841154101
Provider Name (Legal Business Name): EDLUCY INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/11/2025
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
106 W CHERRY ST
HERRIN IL
62948-1737
US
IV. Provider business mailing address
106 W CHERRY ST
HERRIN IL
62948-1737
US
V. Phone/Fax
- Phone: 618-842-2531
- Fax: 618-842-4036
- Phone: 618-842-2531
- Fax: 618-842-4036
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 332B00000X |
| Taxonomy | Durable Medical Equipment & Medical Supplies |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
LUCY
A
POTTS
Title or Position: OWNER
Credential:
Phone: 618-841-1687