Healthcare Provider Details

I. General information

NPI: 1154513539
Provider Name (Legal Business Name): NATASHA L. EDMONDSON PHARM.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/09/2007
Last Update Date: 05/09/2025
Certification Date: 05/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 MOYE BLVD # 119
GREENVILLE NC
27834-2885
US

IV. Provider business mailing address

2762 CRESSET DR
WINTERVILLE NC
28590-6603
US

V. Phone/Fax

Practice location:
  • Phone: 252-830-2149
  • Fax:
Mailing address:
  • Phone: 704-965-1463
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number19340
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: