Provider Demographics
NPI:1487237319
Name:EDWARDS, MADISON MONIQUE (PHARMD)
Entity type:Individual
Prefix:
First Name:MADISON
Middle Name:MONIQUE
Last Name:EDWARDS
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:408 BERRY ST
Mailing Address - Street 2:
Mailing Address - City:BADEN
Mailing Address - State:PA
Mailing Address - Zip Code:15005-1704
Mailing Address - Country:US
Mailing Address - Phone:247-775-4077
Mailing Address - Fax:
Practice Address - Street 1:24 SUMMIT PARK DR
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15275-1104
Practice Address - Country:US
Practice Address - Phone:855-726-8479
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-29
Last Update Date:2021-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP449964183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist