Provider Demographics
NPI:1154332708
Name:DONNA PHARMACY SERVICES LLC
Entity Type:Organization
Organization Name:DONNA PHARMACY SERVICES LLC
Other - Org Name:DONNA PHARMACY SVCS LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:JOE
Authorized Official - Middle Name:
Authorized Official - Last Name:FISCHER
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:956-461-5777
Mailing Address - Street 1:104 N DANIEL SALINAS BLVD
Mailing Address - Street 2:STE C
Mailing Address - City:DONNA
Mailing Address - State:TX
Mailing Address - Zip Code:78537-2926
Mailing Address - Country:US
Mailing Address - Phone:956-461-5777
Mailing Address - Fax:956-461-5777
Practice Address - Street 1:104 N DANIEL SALINAS BLVD
Practice Address - Street 2:STE A
Practice Address - City:DONNA
Practice Address - State:TX
Practice Address - Zip Code:78537-2926
Practice Address - Country:US
Practice Address - Phone:956-461-5777
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-10
Last Update Date:2010-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
TX250933336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
4501385OtherNCPDP PROVIDER IDENTIFICATION NUMBER
TX144788Medicaid