=====================================================
General NPI Number Information
=====================================================
NPI Number | 1124833157
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ONE STOP PHARMA LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/07/2025
-----------------------------------------------------
Last Update Date | 02/07/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5850 RUBEN TORRES SR BLVD STE C5
-----------------------------------------------------
City | BROWNSVILLE
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78526-5206
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 956-621-2090
-----------------------------------------------------
Fax | 956-621-1266
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5850 RUBEN TORRES SR BLVD STE C5
-----------------------------------------------------
City | BROWNSVILLE
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78526-5206
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 956-621-2090
-----------------------------------------------------
Fax | 956-621-1266
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | VICE-PRESIDENT
-----------------------------------------------------
Name | JOSE G VARGAS
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 956-534-6990
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 3336L0003X
-----------------------------------------------------
Taxonomy Name | Long Term Care Pharmacy
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------