Provider Demographics
NPI:1780013680
Name:LA FERIA DRUG
Entity Type:Organization
Organization Name:LA FERIA DRUG
Other - Org Name:THE NEIGHBORHOOD PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:ALBERTO
Authorized Official - Last Name:VELA
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:956-265-9634
Mailing Address - Street 1:1242 E BUS HWY 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:956-583-2714
Practice Address - Street 1:54 E PRICE RD STE 2
Practice Address - Street 2:
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78521-3508
Practice Address - Country:US
Practice Address - Phone:956-550-8908
Practice Address - Fax:956-550-8911
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-01
Last Update Date:2023-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX287863336C0003X, 3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2142846OtherPK
TX149250Medicaid