Provider Demographics
NPI:1962740639
Name:CONWAY, EDWARD PATRICK (PHARMD,RPH)
Entity type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:PATRICK
Last Name:CONWAY
Suffix:
Gender:M
Credentials:PHARMD,RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4720 E COTTON GIN LOOP STE 220
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85040-4823
Mailing Address - Country:US
Mailing Address - Phone:608-334-1558
Mailing Address - Fax:
Practice Address - Street 1:4720 E COTTON GIN LOOP STE 220
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85040-4823
Practice Address - Country:US
Practice Address - Phone:608-334-1558
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-30
Last Update Date:2021-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS020050183500000X
WAPH61012565183500000X
GARPH032634183500000X
WI16782-40183500000X
CA68510183500000X
ORRPH-0016548183500000X
IL051.303205183500000X
TX66552183500000X
NV20420183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist