Healthcare Provider Details

I. General information

NPI: 1932545415
Provider Name (Legal Business Name): MRS. CATHERINE EDWARDS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/10/2013
Last Update Date: 10/07/2025
Certification Date: 10/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7300 W JOY RD
DEXTER MI
48130-9284
US

IV. Provider business mailing address

7300 W JOY RD
DEXTER MI
48130-9284
US

V. Phone/Fax

Practice location:
  • Phone: 855-276-3002
  • Fax: 734-232-3408
Mailing address:
  • Phone: 855-276-3002
  • Fax: 734-232-3408

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number5302028340
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: