Organization
VELACORP PHARMACISTS INC
Active
Other names
San Juan Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN AGEUDO RODRIGUEZ R. PH (OWNER)
(956) 782-6337
Entity
Organization
Contact information
Practice address
1205 N RAUL LONGORIA RD, SUITE F, SAN JUAN, TX 78589-3720
(956) 782-6337
(956) 588-4314
Mailing address
1205 N RAUL LONGORIA RD, SUITE F, SAN JUAN, TX 78589-3720
(956) 782-6337
(956) 588-4314
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
011219501
—
TX
Enumeration date
09/25/2006
Last updated
04/08/2011
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