Provider Demographics
NPI:1497942882
Name:FARMACIA ASSOCIATES OF SAN ANTONIO INC
Entity Type:Organization
Organization Name:FARMACIA ASSOCIATES OF SAN ANTONIO INC
Other - Org Name:MEDI RX DRUGS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CORP SEC TREAS
Authorized Official - Prefix:
Authorized Official - First Name:RICARDO
Authorized Official - Middle Name:
Authorized Official - Last Name:LEAL
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:210-922-1816
Mailing Address - Street 1:6609 BLANCO RD
Mailing Address - Street 2:STE 135
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78216-6152
Mailing Address - Country:US
Mailing Address - Phone:210-212-8100
Mailing Address - Fax:210-212-8105
Practice Address - Street 1:6609 BLANCO RD
Practice Address - Street 2:STE 135
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78216-6152
Practice Address - Country:US
Practice Address - Phone:210-212-8100
Practice Address - Fax:210-212-8105
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-28
Last Update Date:2016-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
TX256933336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2100351OtherPK