Individual ProviderPhillip EdwardsSocial WorkerBehavioral Health & Social Service ProvidersPractice Address4325 Clubhouse Dr Apt H2, Alexandria, LA 71303-3572(318) 792-2564PECOS EnrollmentBased on the most recent information from CMS, provider Phillip Edwards does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 11:13 AM.Profile DetailsProvider ID1396117461Provider TypeIndividualFull NameEdwards, PhillipTitleMr.GenderMaleSole ProprietorYesEnumeration Date10/28/2015Last Updated10/28/2015Contact InformationPractice LocationPractice Address4325 Clubhouse Dr Apt H2, Alexandria, LA 71303-3572Phone(318) 792-2564FaxUnlisted FaxMailing LocationMailing Address4325 Clubhouse Dr Apt H2, Alexandria, LA 71301PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode104100000XPrimaryDescriptionSocial WorkerBehavioral Health & Social Service ProvidersLicense12859Louisiana