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Organization

BUENA VISTA PHARMACY, INC

Active
Other names
Super Drug Mart #5
Organization subpart
No

Provider details

NPI number
Authorized official
MR. RAYMOND D IBANEZ RPH (PRESIDENT)
(210) 674-1900
Entity
Organization

Contact information

Practice address
8920 US HIGHWAY 87 E STE 4A, SAN ANTONIO, TX 78263-2238
(210) 648-9001
(210) 649-9004
Mailing address
8920 US HIGHWAY 87 E STE 4A, SAN ANTONIO, TX 78263-2238
(210) 648-9001
(210) 649-9004

Taxonomy

Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
25658
TX

Other

Enumeration date
07/31/2007
Last updated
07/31/2007
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