Individual
MR. JEROME EDWARDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CPHT
Contact information
Practice address
809 UNIVERSITY BLVD E, TUSCALOOSA, AL 35401-2029
(205) 750-7310
Mailing address
80 CHERRY LN, MOUNDVILLE, AL 35474-2523
(205) 861-9229
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10092398
PTCB
AL
01
—
T-43089
PHARMACY TECHNICIAN
AL
Enumeration date
08/25/2020
Last updated
08/25/2020
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