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Organization

SAN BENITO RX LLC

Active
Other names
FRY'S PRESCRIPTION PHARMACY
Organization subpart
No

Provider details

NPI number
Authorized official
LOKESWARA R KALAKOTI (MANAGER)
(956) 399-2453
Entity
Organization

Contact information

Practice address
311 N SAM HOUSTON BLVD, SAN BENITO, TX 78586-4656
(956) 399-2453
(956) 399-2959
Mailing address
311 N SAM HOUSTON BLVD, SAN BENITO, TX 78586-4656
(956) 399-2453
(956) 399-2959

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
332BX2000X
Oxygen Equipment & Supplies (DME)
3336C0003X
Community/Retail Pharmacy
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
35420
TEXAS STATE BOARD OF PHARMACY
TX
Enumeration date
07/19/2024
Last updated
07/25/2024
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