=====================================================
General NPI Number Information
=====================================================
NPI Number | 1467267567
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | RIDGEPOINT MEDICAL PHARMACY, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/07/2025
-----------------------------------------------------
Last Update Date | 02/07/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 404 S VETERANS BLVD STE C
-----------------------------------------------------
City | EDINBURG
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78539-4721
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 956-393-2000
-----------------------------------------------------
Fax | 956-393-2010
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 404 S VETERANS BLVD STE C
-----------------------------------------------------
City | EDINBURG
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78539-4721
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 956-393-2000
-----------------------------------------------------
Fax | 956-393-2010
-----------------------------------------------------
=====================================================
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 |
-----------------------------------------------------