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Organization

KV EARLY IND

Active
Other names
CANTUS PHARMACY
Organization subpart
No

Provider details

NPI number
Authorized official
ERASMO CANTU (OWNER)
(956) 544-6666
Entity
Organization

Contact information

Practice address
680 PAREDES LINE RD, BROWNSVILLE, TX 78521-2482
(956) 542-6050
(956) 544-5539
Mailing address
1080 E LOS EBANOS BLVD, BROWNSVILLE, TX 78520-9988
(956) 542-6050
(956) 544-5539

Taxonomy

Speciality
Code
Description
License number
State
333600000X
Pharmacy
3336C0003X
Community/Retail Pharmacy
Primary
18322
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
144640
TX
01
4501967
NCPDP PROVIDER IDENTIFICATION NUMBER
Enumeration date
08/25/2006
Last updated
08/02/2012
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