Organization
DE-VINE PHARMACY INC
Active
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
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