Healthcare Provider Details

I. General information

NPI: 1023654027
Provider Name (Legal Business Name): EDWARD LEWIS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/25/2019
Last Update Date: 11/25/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

129-39 EST. ANNAS RETREAT
ST.THOMAS VI
00802
US

IV. Provider business mailing address

PO BOX 1225
ST THOMAS VI
00804-1225
US

V. Phone/Fax

Practice location:
  • Phone: 340-777-8447
  • Fax:
Mailing address:
  • Phone: 340-777-8447
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: