Provider Demographics
NPI:1841590247
Name:UPTOWN PHARMACY LLC
Entity Type:Organization
Organization Name:UPTOWN PHARMACY LLC
Other - Org Name:UPTOWN PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:LADISLAO
Authorized Official - Middle Name:
Authorized Official - Last Name:CARDENAS
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:956-793-2767
Mailing Address - Street 1:110 UPTOWN AVE STE B
Mailing Address - Street 2:
Mailing Address - City:BROWNSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78520-7563
Mailing Address - Country:US
Mailing Address - Phone:956-544-0238
Mailing Address - Fax:956-544-0386
Practice Address - Street 1:110 UPTOWN AVE STE B
Practice Address - Street 2:
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78520-7563
Practice Address - Country:US
Practice Address - Phone:956-544-0238
Practice Address - Fax:956-544-0386
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-01
Last Update Date:2010-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX27068332B00000X, 3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies