Healthcare Provider Details

I. General information

NPI: 1700171592
Provider Name (Legal Business Name): EDWARDS HEALTH CARE SERVICES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/09/2011
Last Update Date: 05/23/2023
Certification Date: 05/23/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9400 WILLIAMSBURG PLAZA SUITE 210
LOUISVILLE KY
40222-5098
US

IV. Provider business mailing address

5640 HUDSON INDUSTRIAL PKWY
HUDSON OH
44236-5011
US

V. Phone/Fax

Practice location:
  • Phone: 888-388-4622
  • Fax:
Mailing address:
  • Phone: 330-655-8379
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WD0400X
TaxonomyDiabetes Educator Registered Nurse
License NumberKY-1385
License Number StateKY

VIII. Authorized Official

Name: MR. DEE E EDWARDS JR.
Title or Position: CHIEF EEXCUTIVE OFFICER,
Credential:
Phone: 330-655-8357