Provider Demographics
NPI:1679910913
Name:DEERFIELD HEALTHCARE, LLC
Entity Type:Organization
Organization Name:DEERFIELD HEALTHCARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:REYNALDO
Authorized Official - Middle Name:
Authorized Official - Last Name:LERMA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-714-0130
Mailing Address - Street 1:100 NE LOOP 410 STE 1500-B
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78216-4700
Mailing Address - Country:US
Mailing Address - Phone:210-714-0130
Mailing Address - Fax:210-634-2818
Practice Address - Street 1:100 NE LOOP 410 STE 1500-B
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78216-4700
Practice Address - Country:US
Practice Address - Phone:210-714-0130
Practice Address - Fax:210-634-2818
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-28
Last Update Date:2020-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy