Provider Demographics
NPI:1578078655
Name:ALAMO RANCH PHARMACY
Entity Type:Organization
Organization Name:ALAMO RANCH PHARMACY
Other - Org Name:ALAMO RANCH PHARMACY & WELLNESS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PIC
Authorized Official - Prefix:DR
Authorized Official - First Name:EUGENIA
Authorized Official - Middle Name:
Authorized Official - Last Name:OSEI-WUSU
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:210-591-1611
Mailing Address - Street 1:5514 LONE STAR PKWY STE 103
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78253-6770
Mailing Address - Country:US
Mailing Address - Phone:210-591-1611
Mailing Address - Fax:210-688-9429
Practice Address - Street 1:5514 LONE STAR PKWY STE 103
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78253
Practice Address - Country:US
Practice Address - Phone:210-413-3099
Practice Address - Fax:210-413-3099
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-11
Last Update Date:2018-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2176889OtherPK