Provider Demographics
NPI:1497877443
Name:FRANK CASTANEDA
Entity Type:Organization
Organization Name:FRANK CASTANEDA
Other - Org Name:AMIGOS PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:MR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:
Authorized Official - Last Name:CASTANEDA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:830-758-1622
Mailing Address - Street 1:PO BOX 805
Mailing Address - Street 2:
Mailing Address - City:EAGLE PASS
Mailing Address - State:TX
Mailing Address - Zip Code:78853-0805
Mailing Address - Country:US
Mailing Address - Phone:830-758-1622
Mailing Address - Fax:
Practice Address - Street 1:1763 E GARRISON ST
Practice Address - Street 2:
Practice Address - City:EAGLE PASS
Practice Address - State:TX
Practice Address - Zip Code:78852-5016
Practice Address - Country:US
Practice Address - Phone:830-758-1622
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-03
Last Update Date:2008-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX17227332B00000X, 3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX610455OtherBLUECROSS MEDICARE BIN #
TX61052OtherAETNA MEDICARE BIN NUMBER
TX014344801Medicaid
TX144461Medicaid
TX610029OtherCAREMARK BIN #
TXCORRECTED NABP#Other4598162
TX012304OtherCOMUNITY CARE RX BIN #
TX610029OtherCAREMARK BIN #
TX112483001Medicare ID - Type UnspecifiedMEDICARE NUMBER
TX014344801Medicaid