Healthcare Provider Details

I. General information

NPI: 1346849643
Provider Name (Legal Business Name): RGVMEDS PHARMACY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/19/2020
Last Update Date: 04/28/2021
Certification Date: 04/28/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2606 E RICHARDSON RD
EDINBURG TX
78542
US

IV. Provider business mailing address

2606 E RICHARDSON RD
EDINBURG TX
78542
US

V. Phone/Fax

Practice location:
  • Phone: 214-650-3918
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: DR. BENJAMIN FOMBON
Title or Position: MEMBER
Credential: PHARMD
Phone: 956-378-9191