Provider Demographics
NPI:1235466467
Name:CAMERON PHARMA L L C
Entity Type:Organization
Organization Name:CAMERON PHARMA L L C
Other - Org Name:LAS PALMAS PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOEL
Authorized Official - Middle Name:
Authorized Official - Last Name:BENITEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-542-7400
Mailing Address - Street 1:864 CENTRAL BLVD STE 1200
Mailing Address - Street 2:
Mailing Address - City:BROWNSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78520-7501
Mailing Address - Country:US
Mailing Address - Phone:956-542-7400
Mailing Address - Fax:956-542-7401
Practice Address - Street 1:864 CENTRAL BLVD STE 1200
Practice Address - Street 2:
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78520-7501
Practice Address - Country:US
Practice Address - Phone:956-542-7400
Practice Address - Fax:956-542-7401
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-09
Last Update Date:2015-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
TX267023336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2122676OtherPK