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Organization
ADVANT EDGE PHARMACY, INC
Active
Organization
ADVANT EDGE PHARMACY, INC
Active
Other names
Advant Edge HME
Organization subpart
No
Provider details
NPI number
Authorized official
MR. EUSTACIO RIVAS JR. RPH (PRESIDENT)
(915) 595-0409
Entity
Organization
Contact information
Practice address
1576 LOMALAND DR, EL PASO, TX 79935-4202
(915) 595-0409
(915) 595-1306
Mailing address
1576 LOMALAND, EL PASO, TX 79935
(915) 595-0409
(915) 595-1306
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
19378
TX
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
19378
TX
332BX2000X
Oxygen Equipment & Supplies (DME)
19378
TX
Other
Enumeration date
09/06/2005
Last updated
09/10/2012
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