Provider Demographics
NPI:1801777206
Name:EDGE MEDICAL SERVICES
Entity type:Organization
Organization Name:EDGE MEDICAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMIN
Authorized Official - Prefix:
Authorized Official - First Name:FAITH
Authorized Official - Middle Name:
Authorized Official - Last Name:BLEVINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-464-3611
Mailing Address - Street 1:1141 N LOOP 1604 E STE 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:888-329-2091
Practice Address - Street 1:2720 STERLING CT
Practice Address - Street 2:
Practice Address - City:WAUKESHA
Practice Address - State:WI
Practice Address - Zip Code:53188-4107
Practice Address - Country:US
Practice Address - Phone:800-348-4623
Practice Address - Fax:888-329-2091
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:EDGE MEDICAL SERVICES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-09-11
Last Update Date:2025-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QB0400XAmbulatory Health Care FacilitiesClinic/CenterBirthing