Provider Demographics
NPI:1104942184
Name:CARY, EDWARD ALAN (RPH)
Entity type:Individual
Prefix:
First Name:EDWARD
Middle Name:ALAN
Last Name:CARY
Suffix:
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 1:7077 OLD MILLSTONE DR
Mailing Address - Street 2:
Mailing Address - City:MECHANICSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:23111-4278
Mailing Address - Country:US
Mailing Address - Phone:804-559-9303
Mailing Address - Fax:
Practice Address - Street 1:2001 MAYWILL ST
Practice Address - Street 2:SUITE 100
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23230-3236
Practice Address - Country:US
Practice Address - Phone:804-340-4057
Practice Address - Fax:804-340-5191
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202009372183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0202009372OtherPHARMACY LICENSE