MEDICARE: EDWARD MADDEN R.PH.

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	33082	CA

General Provider Information

NPI Number	:	1720064033
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EDWARD MADDEN R.PH.

Provider Business Mailing Address
First Line	:	PSC 482 BOX 2579
Second Line	:
City	:	FPO
State	:	AP
Zip	:	96362
Country	:	JP
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	PSC 482 BOX 2579
Second Line	:
City	:	FPO
State	:	AP
Zip	:	96362
Country	:	JP
Telephone Number	:	816117437066
Fax Number	:

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

Provider Enumeration Date	:	12/19/2005
Last Update Date	:	07/08/2007

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Directions to “ EDWARD MADDEN R.PH.” Practice Location

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