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General NPI Number Information
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NPI Number | 1659790244
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Entity Type | Organization
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Legal Business Name | RUIZ PHARMACY
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Dates
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Enumeration Date | 04/10/2014
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Last Update Date | 04/10/2014
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Provider Practice Location Address
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Address Line | 1405 E JEFFERSON ST
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City | BROWNSVILLE
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State | TX
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Zip | 78520-5755
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Country | US
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Telephone | 956-408-4001
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Fax |
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Provider Business Mailing Address
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Address Line | 1405 E JEFFERSON ST
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City | BROWNSVILLE
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State | TX
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Zip | 78520-5755
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Country | US
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Telephone | 956-408-4001
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Fax |
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Authorized Official
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Title or Position | PHARMACIST/OWNER
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Name | RODOLFO RUIZ
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Credential |
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Telephone | 956-408-4001
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0004X
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Taxonomy Name | Compounding Pharmacy
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 28700
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License Number State | TX
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