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Contact Information

ADVANT-EDGE PHARMACY, INC
1576 LOMALAND DR
EL PASO, TX79935-4202
 Phone: 915-595-0409
 Fax: 915-595-1028
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Community/Retail Pharmacy

3336C0003X 58 Medical Supply Company with Pharmacist
 

Durable Medical Equipment & Medical Supplies

332B00000X 54 Other Medical Supply Company
 

Home Infusion Therapy Pharmacy

3336H0001X 58 Medical Supply Company with Pharmacist
 

Long Term Care Pharmacy

3336L0003X 58 Medical Supply Company with Pharmacist
 

Pharmacy

333600000X 58 Medical Supply Company with Pharmacist
Indicates primary specialty

NPI Profile & details for ADVANT-EDGE PHARMACY, INC

NPI # 1003994518
LBN Legal business name ADVANT-EDGE PHARMACY, INC
Authorized official EUSTACIO RIVAS - (PRESIDENT)
Entity Organization
Organization subpart 1 No
Enumeration date 11/01/2006
Last updated 11/13/2023 - About 3 years ago
Identifiers
TX License # 19378
TX Medicaid 144844
Other 2091866 PK
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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