Organization
EDGEWOODRX LLC
Active
Parent organization
EDGEWOODRX LLC
Other names
Edgewood Pharmacy
Organization subpart
Yes
Provider details
NPI number
Legal business name
EDGEWOODRX LLC
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
3336L0003X
Long Term Care Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
149557
—
TX
Enumeration date
11/08/2021
Last updated
11/08/2021
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