Provider Demographics
NPI:1669773172
Name:ABC MENDIOLA ALAMO PHARMACY INC
Entity type:Organization
Organization Name:ABC MENDIOLA ALAMO PHARMACY INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PIC/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AROLDO
Authorized Official - Middle Name:
Authorized Official - Last Name:MENDIOLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-584-9828
Mailing Address - Street 1:115 S ALAMO RD STE B
Mailing Address - Street 2:
Mailing Address - City:ALAMO
Mailing Address - State:TX
Mailing Address - Zip Code:78516-2518
Mailing Address - Country:US
Mailing Address - Phone:956-781-3993
Mailing Address - Fax:956-781-3922
Practice Address - Street 1:115 S ALAMO RD STE B
Practice Address - Street 2:
Practice Address - City:ALAMO
Practice Address - State:TX
Practice Address - Zip Code:78516-2518
Practice Address - Country:US
Practice Address - Phone:956-781-3993
Practice Address - Fax:956-781-3922
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-15
Last Update Date:2011-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX273473336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
5902728OtherNCPDP PROVIDER IDENTIFICATION NUMBER