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NPI Code Detail

MEDICARE: DR. JENNIFER CORRINE EDWARDS PHARMD

MEDICARE: DR. JENNIFER CORRINE 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
1183500000XPharmacist22629NC

General Provider Information

NPI Number : 1932451366
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JENNIFER CORRINE EDWARDS PHARMD
Provider Business Mailing Address
First Line : 10020 PINEVILLE RD
Second Line : UNIT #108
City : RALEIGH
State : NC
Zip : 27617-6326
Country : US
Telephone Number : 423-782-6993
Fax Number :
Provider Business Practice Location Address
First Line : 13304 LEESVILLE CHURCH RD
Second Line :
City : RALEIGH
State : NC
Zip : 27617-5206
Country : US
Telephone Number : 919-845-5276
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/09/2012
Last Update Date : 10/09/2012

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