Provider Demographics
NPI:1639805286
Name:LAREDO FAMILY PHARMACY LLC
Entity Type:Organization
Organization Name:LAREDO FAMILY PHARMACY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:G
Authorized Official - Last Name:VARGAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-583-2700
Mailing Address - Street 1:1242 E BUSINESS HIGHWAY 83 STE 7
Mailing Address - Street 2:
Mailing Address - City:MISSION
Mailing Address - State:TX
Mailing Address - Zip Code:78572-9308
Mailing Address - Country:US
Mailing Address - Phone:956-583-2700
Mailing Address - Fax:956-683-6152
Practice Address - Street 1:313 W VILLAGE BLVD STE 102B
Practice Address - Street 2:
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78041-2275
Practice Address - Country:US
Practice Address - Phone:956-583-2700
Practice Address - Fax:956-683-6152
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-26
Last Update Date:2022-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy