Edgewood Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

02868 Issued in TX

Legal business name

EDGEWOOD PHARMACY INC

Doing business as

Edgewood Pharmacy Inc

Practice address

718 Cupples Rd
San Antonio, TX 78237-4357

Phone

(210) 435-3705

Fax

(210) 435-6721

NPI assigned

Aug 20, 2006

Organization subpart

No

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

Authorized official

Name

Benny Romo

Title

Owner

Phone

(210) 435-3705

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• EDGEWOOD PHARMACY INC Doing business as

Locations

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

{
    "created_epoch": "1156032000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1232064000000",
    "number": "1801901848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "718 CUPPLES RD",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782374357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "718 CUPPLES RD",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782374357",
            "telephone_number": "210-435-3705",
            "fax_number": "210-435-6721"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDGEWOOD PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-20",
        "last_updated": "2009-01-16",
        "status": "A",
        "authorized_official_last_name": "ROMO",
        "authorized_official_first_name": "BENNY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "210-435-3705"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "TX",
            "license": "02868",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "140374",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "4543600",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "EDGEWOOD PHARMACY INC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Edge-MD White, PLLC
• Edge-MD Zarzamora, PLLC
• Jennifer Ann Edgecombe, APRN FNP-BC, FNP-C,
• Kevin Edgerron, LMT
• Edgewood Isd
• Wendell Alan Edgin, DDS
• Joel I. Edionwe, M.D
• Graciela Cecilia Edlund, LVN
• Marvin Edmond
• Cerise Marie Edmonds, LPC ASSOCIATE

• Community/Retail Pharmacy in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Community/Retail Pharmacy in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2009; 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.