Healthcare Provider Details

I. General information

NPI: 1891782785
Provider Name (Legal Business Name): REBECCA M EDWARDS RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 10/05/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 CROSS ST MARSHALL DRUG STORE
URBANNA VA
23175
US

IV. Provider business mailing address

1706 LOVERS RETREAT LN
SALUDA VA
23149-2580
US

V. Phone/Fax

Practice location:
  • Phone: 804-758-5344
  • Fax: 804-758-3366
Mailing address:
  • Phone: 804-758-0541
  • Fax: 804-758-3366

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number0202007199
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: