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General NPI Number Information
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NPI Number | 1275452054
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Entity Type | Organization
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Legal Business Name | EDGE PINE INC
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Dates
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Enumeration Date | 07/14/2026
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Last Update Date | 07/14/2026
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Provider Practice Location Address
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Address Line | 212 W TROY ST STE B
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City | DOTHAN
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State | AL
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Zip | 36303-4455
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Country | US
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Telephone | 773-562-0210
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Fax |
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Provider Business Mailing Address
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Address Line | 1111 N WESTERN AVE UNIT 1N
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City | CHICAGO
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State | IL
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Zip | 60622-5956
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Country | US
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Telephone | 773-562-0210
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | ZOYA ALI
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Credential |
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Telephone | 773-562-0210
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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