Organization
PHARMPLEX LTD III
Active
Other names
Riverside Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
OMAR ESPERICUETA PHARMD (OWNER AND PIC)
(956) 580-3500
Entity
Organization
Contact information
Practice address
2308 EXPRESSWAY 83, SUITE A, PENITAS, TX 78576-8398
(956) 580-3500
(956) 580-3535
Mailing address
2308 EXPRESSWAY 83, SUITE A, PENITAS, TX 78576-8398
(956) 580-3500
(956) 580-3535
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
332BN1400X
Nursing Facility Supplies (DME)
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
24404
TX
3336C0004X
Compounding Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
145610
—
TX
01
—
2098821
PK
—
Enumeration date
05/26/2006
Last updated
04/29/2016
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