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Organization

DOMINYEMED CORPORATION

Active
Other names
City Drug
Organization subpart
No

Provider details

NPI number
Authorized official
MARIO X JUAREZ R.PH. (PRESIDENT/DIRECTOR)
(432) 336-2297
Entity
Organization

Contact information

Practice address
202 E AVE E, ALPINE, TX 79830
(432) 837-2252
(432) 837-3152
Mailing address
202 E AVE E, ALPINE, TX 79830
(432) 837-2252
(432) 837-3152

Taxonomy

Speciality
Code
Description
License number
State
333600000X
Pharmacy
3336C0003X
Community/Retail Pharmacy
Primary
27226
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
5901714
NCPDP PROVIDER IDENTIFICATION NUMBER
Enumeration date
06/27/2010
Last updated
04/12/2021
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