Organization
MEDINA PHARMACY, LLC
Active
Organization
MEDINA PHARMACY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MEAGAN JACOBS (PIC/MANAGING MEMBER)
(210) 404-4538
Entity
Organization
Contact information
Practice address
5563 DEZAVALA ROAD, SUITE 180, SAN ANTONIO, TX 78249
(210) 404-4538
(210) 568-6076
Mailing address
5563 DEZAVALA ROAD, SUITE 180, SAN ANTONIO, TX 78249
(210) 404-4538
(210) 568-6076
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
31384
TX
Other
Enumeration date
05/03/2017
Last updated
05/03/2017
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