Organization
K V EARLY INC
Active
Other names
CANTU SOUTHMOST PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
ERASMO CANTU (OWNER)
(956) 546-7020
Entity
Organization
Contact information
Practice address
3150 INTERNATIONAL BLVD, BROWNSVILLE, TX 78521-3214
(956) 546-7020
(956) 544-5539
Mailing address
14 GALLERIA DR, SAN ANTONIO, TX 78257-1216
(956) 346-1008
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
19714
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
144903
—
TX
01
—
2100793
PK
—
Enumeration date
09/24/2007
Last updated
07/10/2014
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