Provider Demographics
NPI:1760795546
Name:CAPCO, MARIA TERESA FLORES (RPH)
Entity Type:Individual
Prefix:MRS
First Name:MARIA TERESA
Middle Name:FLORES
Last Name:CAPCO
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:82451 US HIGHWAY 111 STE C
Mailing Address - Street 2:
Mailing Address - City:INDIO
Mailing Address - State:CA
Mailing Address - Zip Code:92201-5614
Mailing Address - Country:US
Mailing Address - Phone:760-342-7076
Mailing Address - Fax:760-775-7017
Practice Address - Street 1:82451 US HIGHWAY 111 STE C
Practice Address - Street 2:
Practice Address - City:INDIO
Practice Address - State:CA
Practice Address - Zip Code:92201-5614
Practice Address - Country:US
Practice Address - Phone:760-342-7076
Practice Address - Fax:760-775-7017
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-21
Last Update Date:2010-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA62435183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist