# MERMAID WALKING INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Divine Pharmacy \#2
- **Organization subpart:** No

## Provider details

- **NPI number:** 1629873583
- **Authorized official:** JOSE G VARGAS CPHT (VICE-PRESIDENT)
- **Authorized official phone:** (956) 534-6990

## Contact information

- **Practice address:** 409 W FM 495, SAN JUAN, TX 78589-3717
- **Practice address phone:** (956) 601-0140
- **Practice address fax:** (833) 998-4116
- **Mailing address:** 409 W FM 495, SAN JUAN, TX 78589-3717
- **Mailing address phone:** (956) 601-0140
- **Mailing address fax:** (833) 998-4116

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336L0003X | Long Term Care Pharmacy | — | NULL | Yes |

## Other

- **Enumeration date:** 02/14/2025
- **Last updated:** 02/14/2025