MEDICARE: CT PHARMACY LTD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3336C0003X	Community/Retail Pharmacy	25557	TX

General Provider Information

NPI Number	:	1982812368
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CT PHARMACY LTD

Provider Business Mailing Address
First Line	:	2502 BUDDY OWENS AVE
Second Line	:
City	:	MCALLEN
State	:	TX
Zip	:	78504-5464
Country	:	US
Telephone Number	:	956-971-0600
Fax Number	:	956-971-0601

Provider Business Practice Location Address
First Line	:	2502 BUDDY OWENS AVE
Second Line	:
City	:	MCALLEN
State	:	TX
Zip	:	78504-5464
Country	:	US
Telephone Number	:	956-971-0600
Fax Number	:	956-971-0601

Authorized Official
Title or Position	:	OWNER PHARMACIST
Name	:	MR. MARIO TREVINO
Credential	:	RPH
Telephone Number	:	956-971-0600

Provider Enumeration Date	:	05/18/2007
Last Update Date	:	02/24/2009

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