Organization
DE LA ROSA PHARMACY INC
Active
Other names
De La Rosa Pharmacy & Medical Equipment
Organization subpart
No
Provider details
NPI number
Authorized official
MR. HECTOR EFRAIN DE LA ROSA (C.E.O. OWNER)
(956) 968-8995
Entity
Organization
Contact information
Practice address
1500 E 6TH ST, WESLACO, TX 78596-6606
(956) 968-8995
(956) 969-5728
Mailing address
1500 E 6TH ST, WESLACO, TX 78596-6606
(956) 968-8995
(956) 969-5728
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
12051
TX
3336C0003X
Community/Retail Pharmacy
12051
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12051
ST LICENSE
TX
01
—
4573879
NABP
TX
01
—
530338
BCBS PROVIDER NUMBER
TX
01
—
7442447456
TAX ID
TX
Enumeration date
03/09/2007
Last updated
03/07/2023
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