# ADVANT EDGE PHARMACY, INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1467215483
- **Authorized official:** MR. EUSTACIO RIVAS JR. RPH (PRESIDENT)
- **Authorized official phone:** (915) 595-0409

## Contact information

- **Practice address:** 1576 LOMALAND DR, EL PASO, TX 79935-4202
- **Practice address phone:** (915) 595-0409
- **Practice address fax:** (915) 595-3997
- **Mailing address:** 1576 LOMALAND DR, EL PASO, TX 79935-4202
- **Mailing address phone:** (915) 595-0409
- **Mailing address fax:** (915) 595-3997

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336L0003X | Long Term Care Pharmacy | — | NULL | Yes |

## Other

- **Enumeration date:** 02/01/2024
- **Last updated:** 02/01/2024