Provider Demographics
NPI:1255613154
Name:ALAMO CITY HEALTHCARE LLC
Entity type:Organization
Organization Name:ALAMO CITY HEALTHCARE LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHARMACY MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:RAGHUVEER
Authorized Official - Middle Name:REDDY
Authorized Official - Last Name:CHINTALAPALLY
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:210-858-9606
Mailing Address - Street 1:114 TALAVERA PKWY
Mailing Address - Street 2:1721
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78232-1055
Mailing Address - Country:US
Mailing Address - Phone:210-858-9606
Mailing Address - Fax:
Practice Address - Street 1:114 TALAVERA PKWY
Practice Address - Street 2:1721
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78232-1055
Practice Address - Country:US
Practice Address - Phone:210-858-9606
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-16
Last Update Date:2011-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX45965333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy