Provider Demographics
NPI:1215006168
Name:C&R PHARMACY
Entity Type:Organization
Organization Name:C&R PHARMACY
Other - Org Name:APPLE PHARMACY #5
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:ALBERTO
Authorized Official - Last Name:VELA
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:956-271-1064
Mailing Address - Street 1:2308 EXPRESSWAY 83 STE A
Mailing Address - Street 2:
Mailing Address - City:PENITAS
Mailing Address - State:TX
Mailing Address - Zip Code:78576-8399
Mailing Address - Country:US
Mailing Address - Phone:956-271-1064
Mailing Address - Fax:956-271-1068
Practice Address - Street 1:2308 EXPRESSWAY 83 STE A
Practice Address - Street 2:
Practice Address - City:PENITAS
Practice Address - State:TX
Practice Address - Zip Code:78576-8399
Practice Address - Country:US
Practice Address - Phone:956-271-1064
Practice Address - Fax:956-271-1068
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-07
Last Update Date:2023-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX150545Medicaid
2134727OtherPK