Organization
EDGEWOOD DRUG INC
Active
Other names
EDGEWOOD LEGEND DRUG
Organization subpart
No
Provider details
NPI number
Authorized official
TAMI CRAWFORD R.PH (OWNER)
(903) 896-1473
Entity
Organization
Contact information
Practice address
115 N HOUSTON ST, EDGEWOOD, TX 75117-2502
(903) 896-1473
(903) 896-1481
Mailing address
PO BOX 659, EDGEWOOD, TX 75117-0659
(903) 986-1473
(903) 896-1481
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
6782
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
142867
—
TX
01
—
2102565
PK
—
Enumeration date
10/25/2006
Last updated
02/28/2017
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