Organization
LA BLANCA PHARMACY INC
Active
Other names
LA BLANCA PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
RAFAEL LOPEZ (PIC)
(956) 262-7662
Entity
Organization
Contact information
Practice address
18360 FM 493, STE B, LA BLANCA, TX 78558
(956) 262-7662
(956) 262-7627
Mailing address
2801 S PECAN BLVD, DONNA, TX 78537-6553
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
23203
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
145248
—
TX
01
—
2098248
PK
—
Enumeration date
04/19/2007
Last updated
02/16/2015
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