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General NPI Number Information
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NPI Number | 1639039068
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Entity Type | Organization
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Legal Business Name | EDGEWELL
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Dates
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Enumeration Date | 11/17/2025
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Last Update Date | 11/17/2025
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Provider Practice Location Address
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Address Line | 51 DENNIS ST
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City | EAGLE LAKE
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State | ME
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Zip | 04739-3321
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Country | US
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Telephone | 207-492-9332
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Fax |
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Provider Business Mailing Address
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Address Line | 51 DENNIS ST
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City | EAGLE LAKE
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State | ME
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Zip | 04739-3321
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Country | US
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Telephone | 207-492-9332
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | NNENNA OGWO ONU
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Credential | RN BSN
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Telephone | 207-492-9332
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WA2000X
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Taxonomy Name | Administrator Registered Nurse
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 163WH0200X
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Taxonomy Name | Home Health Registered Nurse
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 163WH1000X
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Taxonomy Name | Hospice Registered Nurse
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 163WG0000X
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Taxonomy Name | General Practice Registered Nurse
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License Number |
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License Number State |
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