Provider Demographics
NPI:1659695328
Name:STARR DME & PHARMACY INC
Entity Type:Organization
Organization Name:STARR DME & PHARMACY INC
Other - Org Name:STARR PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST IN CHARGE
Authorized Official - Prefix:
Authorized Official - First Name:RENE
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTINEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-488-2742
Mailing Address - Street 1:214 CHAPARRAL BLVD
Mailing Address - Street 2:SUITE C
Mailing Address - City:RIO GRANDE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:78582-4613
Mailing Address - Country:US
Mailing Address - Phone:956-488-2742
Mailing Address - Fax:956-488-2771
Practice Address - Street 1:214 CHAPARRAL BLVD
Practice Address - Street 2:SUITE C
Practice Address - City:RIO GRANDE CITY
Practice Address - State:TX
Practice Address - Zip Code:78582-4613
Practice Address - Country:US
Practice Address - Phone:956-488-2742
Practice Address - Fax:956-488-2771
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-24
Last Update Date:2010-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X
TX268523336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
4555174OtherNCPDP PROVIDER IDENTIFICATION NUMBER