Advant-Edge Healthcare

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

25772 Issued in TX

Legal business name

ADVANT-EDGE HEALTHCARE

Practice address

14476 Horizon Blvd
Ste J
Horizon City, TX 79928-8578

Phone

(915) 852-8884

Fax

(915) 852-1727

NPI assigned

Oct 29, 2007

Organization subpart

No

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

Authorized official

Name

Eustacio RivasNPI 1780278408

Title

President

Phone

(915) 309-9343

Specialties & licenses 3

Addresses

Other identifiers 2

Other names 1

• ADVANT EDGE PHARMACY 00002 Doing business as

Tax ID family

Advant Edge Pharmacy 000022 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Advant-Edge Healthcare

  • Long Term Care Pharmacy
  • El Paso, TX
  • NPI 1821853458
  NPD tax ID

Locations

Practitioners 1

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

• Eustacio Rivas Jr.

  • Pharmacist
  • Horizon City, TX
  • NPI 1780278408
  NPD Authorized official

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

{
    "created_epoch": "1193616000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1484265600000",
    "number": "1922287804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14476 HORIZON BLVD",
            "address_2": "STE J",
            "city": "HORIZON CITY",
            "state": "TX",
            "postal_code": "799288578",
            "telephone_number": "915-852-8884",
            "fax_number": "915-852-1727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14476 HORIZON BLVD",
            "address_2": "STE J",
            "city": "HORIZON CITY",
            "state": "TX",
            "postal_code": "799288578",
            "telephone_number": "915-852-8884",
            "fax_number": "915-852-1727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANT-EDGE HEALTHCARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-29",
        "last_updated": "2017-01-13",
        "status": "A",
        "authorized_official_last_name": "RIVAS",
        "authorized_official_first_name": "EUSTACIO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "915-309-9343"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "TX",
            "license": "25772",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "145854",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2100496",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ADVANT EDGE PHARMACY 00002",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• 13650 Eastlake PLLC
• 13660 Horizon Blvd PLLC
• Ariana Abascal
• Eduardo Aguirre, FNP-C
• Iroro Akpovi, PHARMACIST
• Jillian A Alahaydoian
• Albertsons LLC
• Andrea'S Helping Hands, LLC

• Community/Retail Pharmacy in Horizon City, TX
• Providers in Horizon City, 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 13, 2017; 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.