Provider Demographics
NPI:1346849643
Name:RGVMEDS PHARMACY LLC
Entity Type:Organization
Organization Name:RGVMEDS PHARMACY LLC
Other - Org Name:RGVMEDS PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:BENJAMIN
Authorized Official - Middle Name:
Authorized Official - Last Name:FOMBON
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:956-378-9191
Mailing Address - Street 1:2606 E RICHARDSON RD
Mailing Address - Street 2:
Mailing Address - City:EDINBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78542
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2606 E RICHARDSON RD
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78542
Practice Address - Country:US
Practice Address - Phone:214-650-3918
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-19
Last Update Date:2021-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy