Provider Demographics
NPI:1770580417
Name:RIDGEPOINT MEDICAL PHARMACY, LLC
Entity type:Organization
Organization Name:RIDGEPOINT MEDICAL PHARMACY, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:C.E.O./PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:ALBERTO
Authorized Official - Last Name:VELA
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD, RPH
Authorized Official - Phone:956-821-2886
Mailing Address - Street 1:404 S VETERANS BLVD STE C
Mailing Address - Street 2:
Mailing Address - City:EDINBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78539-4721
Mailing Address - Country:US
Mailing Address - Phone:956-393-2000
Mailing Address - Fax:956-393-2010
Practice Address - Street 1:404 S VETERANS BLVD STE C
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78539-4721
Practice Address - Country:US
Practice Address - Phone:956-393-2000
Practice Address - Fax:956-393-2010
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-07
Last Update Date:2024-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX143010001-DMEMedicaid
TX143337702OtherCROSSOVER
TX143337701OtherCCP
TX4518203OtherNABP
TX145051OtherTXM VENDOR
TX145051OtherTXM VENDOR