Healthcare Provider Details

I. General information

NPI: 1134295892
Provider Name (Legal Business Name): LUNAS FRIENDLY PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/27/2006
Last Update Date: 09/09/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2176 E GARRISON ST STE D
EAGLE PASS TX
78852-5071
US

IV. Provider business mailing address

2176 E GARRISON ST STE D
EAGLE PASS TX
78852-5071
US

V. Phone/Fax

Practice location:
  • Phone: 830-752-6088
  • Fax: 830-752-6368
Mailing address:
  • Phone: 830-752-6088
  • Fax: 830-752-6368

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number21019
License Number StateTX

VIII. Authorized Official

Name: HILDA MARTINEZ
Title or Position: PRESIDENT
Credential:
Phone: 830-752-6088