Provider Demographics
NPI:1790846004
Name:LATIN AMERICAN DRUGS, INC
Entity Type:Organization
Organization Name:LATIN AMERICAN DRUGS, INC
Other - Org Name:PHARMACIA LATINA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACY MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:SEAN
Authorized Official - Middle Name:P
Authorized Official - Last Name:YARBROUGH
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:713-695-4332
Mailing Address - Street 1:4000 FULTON ST STE P
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77009-4729
Mailing Address - Country:US
Mailing Address - Phone:713-695-4332
Mailing Address - Fax:713-695-4320
Practice Address - Street 1:4000 FULTON ST STE P
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77009-4729
Practice Address - Country:US
Practice Address - Phone:713-695-4332
Practice Address - Fax:713-695-4320
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX250223336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX145671Medicaid