MEDICARE: KERRI DIANE EDMONDS 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	10521	SC

General Provider Information

NPI Number	:	1659615029
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KERRI DIANE EDMONDS PHARMD

Provider Business Mailing Address
First Line	:	1750 HIGHWAY 160 W
Second Line	:
City	:	FORT MILL
State	:	SC
Zip	:	29708-8009
Country	:	US
Telephone Number	:	803-396-0450
Fax Number	:	803-396-0452

Provider Business Practice Location Address
First Line	:	42 SHELTER COVE LN
Second Line	:
City	:	HILTON HEAD ISLAND
State	:	SC
Zip	:	29928-3543
Country	:	US
Telephone Number	:	843-852-0550
Fax Number	:

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

Provider Enumeration Date	:	11/24/2012
Last Update Date	:	05/20/2026

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