Provider Demographics
NPI:1336327568
Name:SPARKMAN, EDWARD LOUIS (BS,BPH, RPH)
Entity Type:Individual
Prefix:MR
First Name:EDWARD
Middle Name:LOUIS
Last Name:SPARKMAN
Suffix:
Gender:M
Credentials:BS,BPH, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:158 STONETOWN RD
Mailing Address - Street 2:
Mailing Address - City:RINGWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07456-1118
Mailing Address - Country:US
Mailing Address - Phone:973-839-5488
Mailing Address - Fax:973-839-7645
Practice Address - Street 1:85 ACKERMAN AVE
Practice Address - Street 2:
Practice Address - City:CLIFTON
Practice Address - State:NJ
Practice Address - Zip Code:07011-1501
Practice Address - Country:US
Practice Address - Phone:973-253-1911
Practice Address - Fax:973-253-2431
Is Sole Proprietor?:No
Enumeration Date:2008-02-11
Last Update Date:2008-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI01356200183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist