Provider Demographics
NPI:1326177791
Name:JENNINGS, EDWARD (RPH)
Entity Type:Individual
Prefix:MR
First Name:EDWARD
Middle Name:
Last Name:JENNINGS
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2150 PENNSYLVANIA AVE NW RM G-201
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20037-3201
Mailing Address - Country:US
Mailing Address - Phone:202-741-3600
Mailing Address - Fax:202-741-3606
Practice Address - Street 1:2150 PENNSYLVANIA AVE NW RM G-201
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20037-3201
Practice Address - Country:US
Practice Address - Phone:202-741-3600
Practice Address - Fax:202-741-3606
Is Sole Proprietor?:No
Enumeration Date:2007-03-03
Last Update Date:2007-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPH2874183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist