Provider Demographics
NPI:1164524807
Name:RICHARD'S PHARMACY #2 LLC
Entity Type:Organization
Organization Name:RICHARD'S PHARMACY #2 LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/STAFF PHARMACIST
Authorized Official - Prefix:MR
Authorized Official - First Name:RAMIRO
Authorized Official - Middle Name:HUMBERTO
Authorized Official - Last Name:BARRERA
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:956-519-6776
Mailing Address - Street 1:909 BUSINESS PARK DR STE 2
Mailing Address - Street 2:
Mailing Address - City:MISSION
Mailing Address - State:TX
Mailing Address - Zip Code:78572-6054
Mailing Address - Country:US
Mailing Address - Phone:956-519-6777
Mailing Address - Fax:956-519-0443
Practice Address - Street 1:909 BUSINESS PARK DR STE 2
Practice Address - Street 2:
Practice Address - City:MISSION
Practice Address - State:TX
Practice Address - Zip Code:78572-6054
Practice Address - Country:US
Practice Address - Phone:956-519-6777
Practice Address - Fax:956-519-0443
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX19061183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX144867Medicaid