Organization
AMADEO VALENZUELA JR
Active
Other names
FREDS DRUG STORE
Organization subpart
No
Provider details
NPI number
Authorized official
AMADEO VALENZUELA (PRESIDENT)
(956) 748-2141
Entity
Organization
Contact information
Practice address
200 W COLORADO AVE, RIO HONDO, TX 78583
(956) 748-2141
(956) 748-2570
Mailing address
PO BOX 800, RIO HONDO, TX 78583-0800
(956) 748-2141
(956) 748-2570
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
0197
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
144258
—
TX
Enumeration date
10/12/2006
Last updated
07/10/2008
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