Organization
DE LA ROSA PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CYNTHIA SUSTAITA (OFFICE MANAGER)
(956) 968-0403
Entity
Organization
Contact information
Practice address
1500 E 6TH ST, WESLACO, TX 78596-6606
(956) 968-0403
(956) 969-3378
Mailing address
524 W 2ND ST, MERCEDES, TX 78570-2602
(956) 968-8995
(956) 969-5728
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
22810
ST LICENSE
TX
01
—
4581458
NABP
TX
01
—
530338
BCBS - TX
TX
Enumeration date
01/30/2007
Last updated
09/11/2025
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