Provider Demographics
NPI:1588641195
Name:CARTER, EDWARD JERRY (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:JERRY
Last Name:CARTER
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2923 LARRANAGA DR
Mailing Address - Street 2:
Mailing Address - City:THE VILLAGES
Mailing Address - State:FL
Mailing Address - Zip Code:32162-7572
Mailing Address - Country:US
Mailing Address - Phone:352-205-6262
Mailing Address - Fax:
Practice Address - Street 1:2923 LARRANAGA DR
Practice Address - Street 2:
Practice Address - City:THE VILLAGES
Practice Address - State:FL
Practice Address - Zip Code:32162-7572
Practice Address - Country:US
Practice Address - Phone:352-205-6262
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-12-23
Last Update Date:2020-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPU7027183500000X
KY007726183500000X
FLPS39687183500000X
AL20213183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL20213OtherPHARMACIST LICENSE NUMBER
KY007726OtherPHARMACIST LICENSE NUMBER
FLPU7027OtherFLORIDA PHARMACIST CONSULTANT LICENSE
FLPS39687OtherPHARMACIST LICENSE NUMBER