Organization
EDGEWOOD PHARMACY INC
Active
Other names
EDGEWOOD PHARMACY INC
Organization subpart
No
Provider details
NPI number
Authorized official
BENNY ROMO (OWNER)
(210) 435-3705
Entity
Organization
Contact information
Practice address
718 CUPPLES RD, SAN ANTONIO, TX 78237-4357
(210) 435-3705
(210) 435-6721
Mailing address
718 CUPPLES RD, SAN ANTONIO, TX 78237-4357
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
02868
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
140374
—
TX
01
—
4543600
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
08/20/2006
Last updated
01/16/2009
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