Organization
KANUBA INC
Active
Other names
MEDICAL PLAZA PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
ALMA KAFATI RPH (OWNER)
(956) 718-2770
Entity
Organization
Contact information
Practice address
10710 MCPHERSON RD, STE 102, LAREDO, TX 78045-6271
(956) 718-2770
(956) 723-2584
Mailing address
PO BOX 450594, LAREDO, TX 78045-0014
(956) 718-2770
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
25981
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4548131
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
04/29/2008
Last updated
04/03/2012
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