Provider Demographics
NPI:1720545221
Name:UZO NEIGHBORHOOD PHARMACY INC.
Entity Type:Organization
Organization Name:UZO NEIGHBORHOOD PHARMACY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PIC/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WILFRED
Authorized Official - Middle Name:I
Authorized Official - Last Name:OBASI
Authorized Official - Suffix:
Authorized Official - Credentials:PHARM D
Authorized Official - Phone:956-568-5605
Mailing Address - Street 1:1601 JACAMAN RD STE 102
Mailing Address - Street 2:
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78041-6271
Mailing Address - Country:US
Mailing Address - Phone:956-568-5605
Mailing Address - Fax:956-568-5544
Practice Address - Street 1:1601 JACAMAN RD STE 102
Practice Address - Street 2:
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78041-6271
Practice Address - Country:US
Practice Address - Phone:956-568-5605
Practice Address - Fax:965-568-5544
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-21
Last Update Date:2021-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX149987Medicaid