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Individual
MR. EDWIN RAY POTTS
Active
Individual
MR. EDWIN RAY POTTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPH
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
332B00000X
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0009632011
BLUE CROSS BLUE SHIELD
IL
01
—
1453531
NABP
IL
05
—
371200692001
—
IL
Enumeration date
05/09/2006
Last updated
07/16/2008
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