Provider Demographics
NPI:1124309927
Name:EDWARDS, WILLIAM VENDEL (RPH)
Entity type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:VENDEL
Last Name:EDWARDS
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 1:3233 MARTIN LUTHER KING JR BLVD
Mailing Address - Street 2:
Mailing Address - City:ANDERSON
Mailing Address - State:SC
Mailing Address - Zip Code:29625-1714
Mailing Address - Country:US
Mailing Address - Phone:864-226-0522
Mailing Address - Fax:864-222-2089
Practice Address - Street 1:3233 MARTIN LUTHER KING JR BLVD
Practice Address - Street 2:
Practice Address - City:ANDERSON
Practice Address - State:SC
Practice Address - Zip Code:29625-1714
Practice Address - Country:US
Practice Address - Phone:864-226-0522
Practice Address - Fax:864-222-2089
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-07
Last Update Date:2011-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3945183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist