Organization
GREEN RAVEN INC
Active
Other names
RINGGOLD PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
JUAN GARCIA (OWNER)
(956) 849-3476
Entity
Organization
Contact information
Practice address
1623 E HIGHWAY 83, RIO GRANDE CITY, TX 78582
(956) 488-1660
(956) 488-1491
Mailing address
1623 E HIGHWAY 83, RIO GRANDE CITY, TX 78582
(956) 488-1660
(956) 488-1491
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
Primary
—
—
3336C0003X
Community/Retail Pharmacy
25613
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2099571
PK
—
05
—
4531376
—
TX
Enumeration date
09/05/2006
Last updated
04/29/2025
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