Provider Demographics
NPI:1689966590
Name:BATTJES, EDWARD NICHOLAS (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:NICHOLAS
Last Name:BATTJES
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 1:837 CEDAR ST STE 100
Mailing Address - Street 2:
Mailing Address - City:SOUTH BEND
Mailing Address - State:IN
Mailing Address - Zip Code:46617-2000
Mailing Address - Country:US
Mailing Address - Phone:574-237-7338
Mailing Address - Fax:
Practice Address - Street 1:837 CEDAR ST STE 100
Practice Address - Street 2:
Practice Address - City:SOUTH BEND
Practice Address - State:IN
Practice Address - Zip Code:46617-2000
Practice Address - Country:US
Practice Address - Phone:574-237-7338
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-10
Last Update Date:2021-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26023598A1835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist