Organization
BUENA VISTA PHARMACY, INC.
Active
Other names
dba Super Drug Mart #4
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RAYMOND D IBANEZ RPH (PRESIDENT PHARMACIST IN CHARGE)
(210) 674-1900
Entity
Organization
Contact information
Practice address
7323 MARBACH RD STE 105, SAN ANTONIO, TX 78227-1905
(210) 674-1900
(210) 674-5404
Mailing address
7323 MARBACH RD STE 105, SAN ANTONIO, TX 78227-1905
(210) 674-1900
(210) 674-5404
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
18224
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010729401
—
TX
05
—
016578901
—
TX
05
—
067296601
—
TX
05
—
142614
—
TN
01
—
4567270
NABP
TX
Enumeration date
03/15/2007
Last updated
12/02/2013
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us