Provider Demographics
NPI:1942898002
Name:PHARMAVIDA RX INC
Entity Type:Organization
Organization Name:PHARMAVIDA RX INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:ERNESTO
Authorized Official - Middle Name:MARTIN
Authorized Official - Last Name:MALAGA-CARPIO
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:956-553-2116
Mailing Address - Street 1:2116 W GRIFFIN PKWY STE A
Mailing Address - Street 2:
Mailing Address - City:PALMVIEW
Mailing Address - State:TX
Mailing Address - Zip Code:78572-9733
Mailing Address - Country:US
Mailing Address - Phone:956-553-2116
Mailing Address - Fax:
Practice Address - Street 1:2116 W GRIFFIN PKWY STE A
Practice Address - Street 2:
Practice Address - City:PALMVIEW
Practice Address - State:TX
Practice Address - Zip Code:78572-9733
Practice Address - Country:US
Practice Address - Phone:956-553-2116
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PHARMAVIDA RX
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-01-05
Last Update Date:2021-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy