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Organization
EDGEWOODRX LLC
Active
Organization
EDGEWOODRX LLC
Active
Parent organization
EDGEWOODRX LLC
Other names
Edgewood Pharmacy
Organization subpart
Yes
Provider details
NPI number
Legal business name
EDGEWOODRX LLC
Authorized official
KEYUR MODI RPH (PRESIDENT/PHARMACIST IN CHARGE)
(281) 993-4779
Entity
Organization
Contact information
Practice address
186 S FRIENDSWOOD DR, FRIENDSWOOD, TX 77546-3915
(281) 993-4779
(832) 569-4756
Mailing address
186 S FRIENDSWOOD DR, FRIENDSWOOD, TX 77546-3915
(281) 993-4779
(832) 569-4756
Taxonomy
Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
149557
—
TX
Enumeration date
11/08/2021
Last updated
11/08/2021
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