Derek Edlund, PHARM D
Individual provider Active NPI Pharmacist · Fremont, MI
NPI 1669820494 · NPPES record last updated Jun 2, 2016
Key facts
- NPI
- 1669820494
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 5302040792 (MI)
- Practice address
- 819 W Main St
Fremont, MI 49412-1416 - Phone
- (231) 924-2360
- NPI assigned
- Jun 2, 2016
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5302040792 | MI | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 5302040792 | MI | Yes |
Addresses
Primary practice location
819 W Main St
Fremont, MI 49412-1416
Mailing address
819 W Main St
Fremont, MI 49412-1416
Phone (231) 924-2360
Other providers in Fremont, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 2, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.