# MEDICAL CENTER PHARMACY, LTD.CO

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- **Entity:** Organization
- **Status:** Active
- **Other names:** MEDICAL CENTER PHARMACY-STONE OAK
- **Organization subpart:** No

## Provider details

- **NPI number:** 1861870123
- **Authorized official:** LUIS VALDIVIESO III PHARM.D. (PHARMACIST-IN-CHARGE)
- **Authorized official phone:** (210) 833-1935

## Contact information

- **Practice address:** 540 OAK CENTRE DRIVE, SUITE 153, SAN ANTONIO, TX 78258-3937
- **Practice address phone:** (210) 332-9862
- **Practice address fax:** (210) 332-9585
- **Mailing address:** 540 OAK CENTRE DRIVE, SUITE 153, SAN ANTONIO, TX 78258-3937
- **Mailing address phone:** (210) 332-9862
- **Mailing address fax:** (210) 332-9585

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0003X | Community/Retail Pharmacy | 29710 | TX | — |
| 3336C0004X | Compounding Pharmacy | 29710 | TX | Yes |

## Other

- **Enumeration date:** 05/07/2015
- **Last updated:** 03/02/2016