Provider Demographics
NPI:1508635020
Name:EDGE MEDICAL SERVICES
Entity Type:Organization
Organization Name:EDGE MEDICAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE STAFF
Authorized Official - Prefix:
Authorized Official - First Name:NORA
Authorized Official - Middle Name:
Authorized Official - Last Name:HERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-348-4623
Mailing Address - Street 1:1141 N LOOP 1604 E # 105187
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78232-1339
Mailing Address - Country:US
Mailing Address - Phone:800-348-4623
Mailing Address - Fax:800-348-4623
Practice Address - Street 1:2300 SUTTER ST STE 301
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94115-3029
Practice Address - Country:US
Practice Address - Phone:800-348-4623
Practice Address - Fax:800-348-4623
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:EDGE MEDICAL SERVICES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-12-26
Last Update Date:2023-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital