Organization
EDGE MEDICAL LLC
Active
Other names
EDGE MEDICAL LLC
Organization subpart
No
Provider details
NPI number
Authorized official
LESLIE BAKER RPH (CHIEF PHARMACIST)
(775) 829-0774
Entity
Organization
Contact information
Practice address
5875 TYRONE RD, RENO, NV 89502-6248
(775) 829-0774
(775) 829-0217
Mailing address
PO BOX 17220, RENO, NV 89511-7220
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PH02207
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2990732
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
01/02/2008
Last updated
04/09/2009
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