Healthcare Provider Details

I. General information

NPI: 1184994436
Provider Name (Legal Business Name): VERENICE OLMEDA PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: VERENICE OLMEDA PHARMACY DOCTOR

II. Dates (important events)

Enumeration Date: 01/04/2012
Last Update Date: 12/11/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1418 E UNIVERSITY DR
EDINBURG TX
78539-3710
US

IV. Provider business mailing address

1418 E UNIVERSITY DR
EDINBURG TX
78539-3710
US

V. Phone/Fax

Practice location:
  • Phone: 956-380-6551
  • Fax:
Mailing address:
  • Phone: 956-380-6551
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number48924
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: