Organization
CKS HEALTHCARE /INC.
Active
Other names
Lakeside Pharmacy South
Organization subpart
No
Provider details
NPI number
Authorized official
YVONNE COMPEAN (PHARMACY MANAGER)
(956) 724-2090
Entity
Organization
Contact information
Practice address
4151 JAIME ZAPATA MEMORIAL HWY STE 208, LAREDO, TX 78043-4782
(956) 724-2090
(956) 724-2170
Mailing address
4151 JAIME ZAPATA MEMORIAL HWY STE 208, LAREDO, TX 78043-4782
(956) 724-2090
(956) 724-2170
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
30892
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
149502
—
TX
01
—
2164466
PK
—
Enumeration date
08/12/2015
Last updated
07/19/2018
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