MR. Edsel Ray Black SR., RPH

NPI #1881903888 in Cleveland, Georgia

Provider Information

NPI Number: 1881903888
Entity Type: Individual
Name: MR. Edsel Ray Black SR., RPH
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Pharmacist
Credential: RPH
Enumeration Date: Sep 25, 2010
Last Updated: Apr 19, 2022

Practice Location

Address: 184 W KYTLE ST STE A
City: Cleveland
State: Georgia
ZIP Code: 30528-9607
Phone: (706) 219-2626

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pharmacist	183500000X	Primary

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