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Organization

DE-VINE PHARMACY INC

Active
Other names
DE VINE PHARMACY
Organization subpart
No

Provider details

NPI number
Authorized official
IFEYINWA E RPH (OWNER/PRESIDENT)
(915) 845-7600
Entity
Organization

Contact information

Practice address
840 E REDD RD, EL PASO, TX 79912-7264
(915) 845-7600
(915) 845-7601
Mailing address
840 E REDD RD, BLDG #1A, EL PASO, TX 79912-7264
(915) 845-7600
(915) 845-7601

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
333600000X
Pharmacy
3336C0003X
Community/Retail Pharmacy
Primary
25508
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
145802
TX
01
4544599
NCPDP PROVIDER IDENTIFICATION NUMBER
Enumeration date
04/25/2007
Last updated
06/30/2010
About Stedi
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