Organization
PHARMPLEX LTD III
Active
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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