Provider Demographics
NPI:1891068011
Name:EDWARDS MEDICAL
Entity Type:Organization
Organization Name:EDWARDS MEDICAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LOETTA
Authorized Official - Middle Name:
Authorized Official - Last Name:EDWARDS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:856-389-5137
Mailing Address - Street 1:PO BOX 594
Mailing Address - Street 2:
Mailing Address - City:MOUNT LAUREL
Mailing Address - State:NJ
Mailing Address - Zip Code:08054-0594
Mailing Address - Country:US
Mailing Address - Phone:856-389-5137
Mailing Address - Fax:
Practice Address - Street 1:101 ROUTE 130 S
Practice Address - Street 2:SUITE 426
Practice Address - City:CINNAMINSON
Practice Address - State:NJ
Practice Address - Zip Code:08077-2845
Practice Address - Country:US
Practice Address - Phone:856-389-5137
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-18
Last Update Date:2013-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies