Provider Demographics
NPI:1003984030
Name:INTERNATIONAL PHARMACIES
Entity Type:Organization
Organization Name:INTERNATIONAL PHARMACIES
Other - Org Name:LINDALE PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST IN CHARGE
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:ROLANDO
Authorized Official - Last Name:OLVERA
Authorized Official - Suffix:SR
Authorized Official - Credentials:PHARMACIST
Authorized Official - Phone:956-546-3741
Mailing Address - Street 1:500 PAREDAS LINE RD
Mailing Address - Street 2:SUITE #8
Mailing Address - City:BROWNSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78521
Mailing Address - Country:US
Mailing Address - Phone:956-546-3741
Mailing Address - Fax:956-546-5254
Practice Address - Street 1:500 PAREDAS LINE RD
Practice Address - Street 2:
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78521
Practice Address - Country:US
Practice Address - Phone:956-546-3741
Practice Address - Fax:956-546-5254
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX161223336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX142970Medicaid
TX142970Medicaid