Provider Demographics
NPI:1134295892
Name:LUNAS FRIENDLY PHARMACY INC
Entity Type:Organization
Organization Name:LUNAS FRIENDLY PHARMACY INC
Other - Org Name:FRIENDLY PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HILDA
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTINEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:830-752-6088
Mailing Address - Street 1:2176 E GARRISON ST
Mailing Address - Street 2:STE D
Mailing Address - City:EAGLE PASS
Mailing Address - State:TX
Mailing Address - Zip Code:78852-5071
Mailing Address - Country:US
Mailing Address - Phone:830-752-6088
Mailing Address - Fax:830-752-6368
Practice Address - Street 1:2176 E GARRISON ST
Practice Address - Street 2:STE D
Practice Address - City:EAGLE PASS
Practice Address - State:TX
Practice Address - Zip Code:78852-5071
Practice Address - Country:US
Practice Address - Phone:830-752-6088
Practice Address - Fax:830-752-6368
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-27
Last Update Date:2016-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
TX210193336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX145093Medicaid
2095847OtherPK
5535260001Medicare NSC