Provider Demographics
NPI:1558949727
Name:NORTH LOOP VENTURES INC
Entity Type:Organization
Organization Name:NORTH LOOP VENTURES INC
Other - Org Name:NORTH LOOP PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST IN CHARGE
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:MANCHA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:915-444-8124
Mailing Address - Street 1:8825 N LOOP DR STE 107
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79907-4607
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8825 N LOOP DR STE 107
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79907-4607
Practice Address - Country:US
Practice Address - Phone:915-444-8124
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-30
Last Update Date:2021-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy