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Organization
LOS EBANOS PHARMACY,LLC
Active
Organization
LOS EBANOS PHARMACY,LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT J DE LACHICA R.PH. (OWNER)
(956) 542-8542
Entity
Organization
Contact information
Practice address
1134 E LOS EBANOS BLVD, BROWNSVILLE, TX 78520-8730
(956) 542-8542
(956) 542-0044
Mailing address
1134 E LOS EBANOS BLVD, BROWNSVILLE, TX 78520-8730
(956) 542-8542
(956) 542-0044
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
02302
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
141943
—
TX
01
—
4503810
NCPDP NUMBER
TX
Enumeration date
05/27/2005
Last updated
09/19/2008
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