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NPI Code Detail

MEDICARE: MR. ROBERT WESLEY EDWARDS JR. RPH

MEDICARE: MR. ROBERT WESLEY EDWARDS JR. RPH
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
11835G0303XGeriatric Pharmacist4789NC

General Provider Information

NPI Number : 1649566563
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. ROBERT WESLEY EDWARDS JR. RPH
Provider Business Mailing Address
First Line : 7309 GRAY GABLES LN
Second Line :
City : WILMINGTON
State : NC
Zip : 28403-3747
Country : US
Telephone Number : 910-619-1797
Fax Number :
Provider Business Practice Location Address
First Line : 4711 NEW CENTRE DR
Second Line :
City : WILMINGTON
State : NC
Zip : 28405-3442
Country : US
Telephone Number : 910-395-0749
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/20/2011
Last Update Date : 06/20/2011

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