Organization
MEDICAL EDGE HEALTHCARE GROUP PA
Active
Other names
HEALTHEDGE INFUSION THERAPEUTICS
Organization subpart
No
Provider details
NPI number
Authorized official
CLAY HEIGHTEN RPH (PRESIDENT)
(972) 739-3001
Entity
Organization
Contact information
Practice address
15800 DOOLEY RD, STE 120, ADDISON, TX 75001-4284
(972) 788-0592
(972) 788-0697
Mailing address
PO BOX 650268, DALLAS, TX 75265-0268
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
25255
TX
3336C0004X
Compounding Pharmacy
—
—
3336H0001X
Home Infusion Therapy Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4548864
OTHER ID NUMBER
—
Enumeration date
10/17/2006
Last updated
06/01/2010
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