Provider Demographics
NPI:1881281442
Name:WEST, EDWARD (PHARMACIST)
Entity type:Individual
Prefix:
First Name:EDWARD
Middle Name:
Last Name:WEST
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 844
Mailing Address - Street 2:
Mailing Address - City:HILLSBORO
Mailing Address - State:TX
Mailing Address - Zip Code:76645-0844
Mailing Address - Country:US
Mailing Address - Phone:254-582-5363
Mailing Address - Fax:254-582-7429
Practice Address - Street 1:101 JANE LN
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:TX
Practice Address - Zip Code:76645-2673
Practice Address - Country:US
Practice Address - Phone:254-582-5363
Practice Address - Fax:254-582-7429
Is Sole Proprietor?:No
Enumeration Date:2020-12-29
Last Update Date:2020-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX34286183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist