Organization
EDGEWOODRX LLC
Active
Other names
Edgewood Pharmacy
Organization subpart
No
Provider details
NPI number
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
333600000X
Pharmacy
Primary
31057
TX
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
149557
—
TX
01
—
2165750
PK
—
Enumeration date
10/16/2016
Last updated
11/08/2021
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