Provider Demographics
NPI:1649566563
Name:EDWARDS, ROBERT WESLEY JR (RPH)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:WESLEY
Last Name:EDWARDS
Suffix:JR
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 1:7309 GRAY GABLES LN
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28403-3747
Mailing Address - Country:US
Mailing Address - Phone:910-619-1797
Mailing Address - Fax:
Practice Address - Street 1:4711 NEW CENTRE DR
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28405-3442
Practice Address - Country:US
Practice Address - Phone:910-395-0749
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-20
Last Update Date:2011-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC47891835G0303X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835G0303XPharmacy Service ProvidersPharmacistGeriatric