Provider Demographics
NPI:1558516278
Name:EDWARDS, DAMESHIA (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:DAMESHIA
Middle Name:
Last Name:EDWARDS
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4646 JOHN R
Mailing Address - Street 2:JOHN D. DINGELL MEDICAL CENTER-PHARMACY
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48201
Mailing Address - Country:US
Mailing Address - Phone:313-576-1135
Mailing Address - Fax:313-576-1105
Practice Address - Street 1:4646 JOHN R ST
Practice Address - Street 2:OUTPATIENT PHARMACY #118-CP
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48201
Practice Address - Country:US
Practice Address - Phone:313-576-1135
Practice Address - Fax:313-576-1105
Is Sole Proprietor?:No
Enumeration Date:2008-11-21
Last Update Date:2018-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302033657183500000X, 1835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No183500000XPharmacy Service ProvidersPharmacist