Provider Demographics
NPI:1740436385
Name:EDGE MEDICAL SOLUTIONS
Entity type:Organization
Organization Name:EDGE MEDICAL SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:GERALD
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:WHITE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-340-6771
Mailing Address - Street 1:1 ALTIMIRA ST.
Mailing Address - Street 2:
Mailing Address - City:COTO DE CAZA
Mailing Address - State:CA
Mailing Address - Zip Code:92679
Mailing Address - Country:US
Mailing Address - Phone:949-340-6771
Mailing Address - Fax:949-340-7591
Practice Address - Street 1:1 ALTIMIRA
Practice Address - Street 2:
Practice Address - City:COTO DE CAZA
Practice Address - State:CA
Practice Address - Zip Code:92679-4901
Practice Address - Country:US
Practice Address - Phone:949-340-6771
Practice Address - Fax:949-340-7591
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-14
Last Update Date:2008-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies