Organization
DE LA ROSA PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CYNTHIA SUSTAITA (OFFICE MANAGER)
(956) 585-9110
Entity
Organization
Contact information
Practice address
1112 E GRIFFIN PKWY, MISSION, TX 78572-2407
(956) 585-9110
(956) 969-3378
Mailing address
1112 E GRIFFIN PKWY, MISSION, TX 78572-2407
(956) 585-9110
(956) 969-3378
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
—
—
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
530338
BCBS - TX
TX
Enumeration date
01/30/2007
Last updated
09/11/2025
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