Advant Edge Pharmacy, Inc

Primary specialty

Long Term Care PharmacyTaxonomy code 3336L0003X

Legal business name

ADVANT EDGE PHARMACY, INC

Practice address

1576 Lomaland Dr
El Paso, TX 79935-4202

Phone

(915) 595-0409

Fax

(915) 595-3997

NPI assigned

Feb 1, 2024

Last updated

Feb 1, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Eustacio Rivas Jr., RPHNPI 1780278408

Title

President

Phone

(915) 595-0409

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Eustacio Rivas Jr.

  • Pharmacist
  • Horizon City, TX
  • NPI 1780278408
  Authorized official Same address or phone

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

{
    "created_epoch": "1706745600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1706745600000",
    "number": "1467215483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1576 LOMALAND DR",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799354202",
            "telephone_number": "915-595-0409",
            "fax_number": "915-595-3997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1576 LOMALAND DR",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799354202",
            "telephone_number": "915-595-0409",
            "fax_number": "915-595-3997"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANT EDGE PHARMACY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-02-01",
        "last_updated": "2024-02-01",
        "certification_date": "2024-02-01",
        "status": "A",
        "authorized_official_last_name": "RIVAS",
        "authorized_official_first_name": "EUSTACIO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "915-595-0409",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Long Term Care Pharmacy in El Paso, TX
• Providers in El Paso, TX by specialty
• Long Term Care Pharmacy in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2024; 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.