Edgewoodrx LLC

Primary specialty

PharmacyTaxonomy code 333600000X

License

31057 Issued in TX

Legal business name

EDGEWOODRX LLC

Practice address

186 S Friendswood Dr
Friendswood, TX 77546-3915

Phone

(281) 993-4779

Fax

(832) 569-4756

NPI assigned

Oct 16, 2016

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Keyur Modi, RPHNPI 1205004439

Title

President / Pharmacist in Charge

Phone

(281) 993-4779

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Edgewood Pharmacy Doing business as

Locations

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Edgewoodrx LLC

  • Long Term Care Pharmacy
  • Friendswood, TX
  • NPI 1235894965
  NPPES parent name

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Keyur D Modi, R.PH

  • Pharmacist
  • Friendswood, TX
  • NPI 1205004439
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1476576000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1636329600000",
    "number": "1144771007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "186 S FRIENDSWOOD DR",
            "city": "FRIENDSWOOD",
            "state": "TX",
            "postal_code": "775463915",
            "telephone_number": "281-993-4779",
            "fax_number": "832-569-4756"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "186 S FRIENDSWOOD DR",
            "city": "FRIENDSWOOD",
            "state": "TX",
            "postal_code": "775463915",
            "telephone_number": "281-993-4779",
            "fax_number": "832-569-4756"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDGEWOODRX LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-16",
        "last_updated": "2021-11-08",
        "certification_date": "2021-11-08",
        "status": "A",
        "authorized_official_last_name": "MODI",
        "authorized_official_first_name": "KEYUR",
        "authorized_official_title_or_position": "PRESIDENT / PHARMACIST IN CHARGE",
        "authorized_official_telephone_number": "281-993-4779",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "TX",
            "license": "31057",
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2165750",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "149557",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Edgewood Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Edgewood Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Pharmacy in Friendswood, TX
• Providers in Friendswood, TX by specialty
• Pharmacy in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.