MEDICARE: MS. KARI JO EDWARDS PHARMD.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	014136	KY

General Provider Information

NPI Number	:	1407082498
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. KARI JO EDWARDS PHARMD.

Provider Business Mailing Address
First Line	:	717 OAK ST
Second Line	:
City	:	MADISONVILLE
State	:	KY
Zip	:	42431-2873
Country	:	US
Telephone Number	:	270-836-6965
Fax Number	:

Provider Business Practice Location Address
First Line	:	920 N MAIN ST
Second Line	:
City	:	MADISONVILLE
State	:	KY
Zip	:	42431-1262
Country	:	US
Telephone Number	:	270-825-4770
Fax Number	:	270-824-9139

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/03/2009
Last Update Date	:	06/03/2009

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