Provider Demographics
NPI:1376836809
Name:PEOPLES PREFERRED PHARMACY LLC
Entity Type:Organization
Organization Name:PEOPLES PREFERRED PHARMACY LLC
Other - Org Name:THE MEDICINE SHOPPE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:HR DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ROSIE
Authorized Official - Middle Name:
Authorized Official - Last Name:VELA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-723-2911
Mailing Address - Street 1:819 CORPUS CHRISTI ST
Mailing Address - Street 2:
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78040-5261
Mailing Address - Country:US
Mailing Address - Phone:956-723-2911
Mailing Address - Fax:956-723-5555
Practice Address - Street 1:3620 N ARKANSAS AVE STE E
Practice Address - Street 2:
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78043-1116
Practice Address - Country:US
Practice Address - Phone:956-729-0311
Practice Address - Fax:956-753-2954
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-17
Last Update Date:2013-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X
TX275703336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX4522420005OtherMEDICARE PTAN
5903338OtherNCPDP PROVIDER IDENTIFICATION NUMBER