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General NPI Number Information
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NPI Number | 1184895724
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Entity Type | Organization
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Legal Business Name | FRED'S PHARMACY
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Dates
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Enumeration Date | 03/21/2008
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Last Update Date | 04/22/2008
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Provider Practice Location Address
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Address Line | 2790 PHARMACY RD STE A
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City | RIO GRANDE CITY
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State | TX
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Zip | 78582-6547
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Country | US
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Telephone | 956-487-2711
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Fax | 956-487-6399
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Provider Business Mailing Address
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Address Line | 2790 PHARMACY RD STE A
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City | RIO GRANDE CITY
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State | TX
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Zip | 78582-6547
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Country | US
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Telephone | 956-487-2711
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Fax | 956-487-6399
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Authorized Official
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Title or Position | PHARMACIST
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Name | MR. FRANK R GARCIA
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Credential | R.PH.
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Telephone | 956-487-2711
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 15025
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License Number State | TX
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