Healthcare Provider Details

I. General information

NPI: 1063748408
Provider Name (Legal Business Name): CARL GENE EDWARDS JR. PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/20/2009
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6030 US HIGHWAY 301 S
FOUR OAKS NC
27524-7420
US

IV. Provider business mailing address

6030 US HIGHWAY 301 S
FOUR OAKS NC
27524-7420
US

V. Phone/Fax

Practice location:
  • Phone: 919-980-4031
  • Fax: 919-980-4032
Mailing address:
  • Phone: 919-980-4031
  • Fax: 919-980-4032

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number13009
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: