Organization
EXPRESSWAY PHARMACY LLC
Active
Other names
Expressway Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MARIO TREVINO (PIC)
(956) 464-7600
Entity
Organization
Contact information
Practice address
702 E EXPRESSWAY 83, STE A1, DONNA, TX 78537-2741
(956) 464-7600
(956) 464-7601
Mailing address
702 E EXPRESSWAY 83, STE A1, DONNA, TX 78537-2741
(956) 464-7600
(956) 464-7601
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
26226
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4550302
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
10/23/2008
Last updated
11/07/2012
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