Provider Demographics
NPI:1174813653
Name:EDWARDS, LUISA MARIA (RPH)
Entity Type:Individual
Prefix:MRS
First Name:LUISA
Middle Name:MARIA
Last Name:EDWARDS
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 ROGUE DR
Mailing Address - Street 2:
Mailing Address - City:WESTPORT
Mailing Address - State:MA
Mailing Address - Zip Code:02790-4365
Mailing Address - Country:US
Mailing Address - Phone:508-636-0076
Mailing Address - Fax:
Practice Address - Street 1:1024 S MAIN ST
Practice Address - Street 2:
Practice Address - City:FALL RIVER
Practice Address - State:MA
Practice Address - Zip Code:02724-2820
Practice Address - Country:US
Practice Address - Phone:508-672-0888
Practice Address - Fax:508-676-1864
Is Sole Proprietor?:No
Enumeration Date:2011-04-18
Last Update Date:2011-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPH21903183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist