Organization
FIESTA LIFECARE PHARMACY 8 LLC
Active
Other names
Lifecare Pharmcy Freer
Organization subpart
No
Provider details
NPI number
Authorized official
PREM KALIDINDI (MANAGER/OWNER)
(917) 769-8014
Entity
Organization
Contact information
Practice address
412 E RILEY ST, FREER, TX 75063
(361) 394-5151
Mailing address
PO BOX 12929, SAN ANTONIO, TX 78212-0929
(917) 769-8014
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Enumeration date
10/29/2019
Last updated
10/29/2019
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