# ADVANT EDGE PHARMACY, INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Advant Edge HME
- **Organization subpart:** No

## Provider details

- **NPI number:** 1477547552
- **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) 595-1306
- **Mailing address:** 1576 LOMALAND, EL PASO, TX 79935
- **Mailing address phone:** (915) 595-0409
- **Mailing address fax:** (915) 595-1306

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | 19378 | TX | Yes |
| 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