Organization
PRESIDIO PHARMACY INC
Active
Other names
Presidio Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MARIO X JUAREZ R.PH. (PRESIDENT/OWNER)
(432) 336-2297
Entity
Organization
Contact information
Practice address
1501 B NORTH ERMA AVE, PRESIDIO, TX 79845
(432) 229-2252
(432) 229-3152
Mailing address
PO BOX 2044, PRESIDIO, TX 79845-2044
(432) 229-2252
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
31099
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
31099
PHARMACY LICENSE NUMBER
TX
Enumeration date
12/19/2016
Last updated
01/23/2017
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