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General NPI Number Information
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NPI Number | 1669517801
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Entity Type | Organization
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Legal Business Name | VALLEY BAPTIST MEDICAL CENTER
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Dates
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Enumeration Date | 02/21/2007
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Last Update Date | 07/30/2010
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Provider Practice Location Address
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Address Line | 2101 PEASE ST EAST TOWER
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City | HARLINGEN
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State | TX
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Zip | 78550-8307
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Country | US
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Telephone | 956-389-6898
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Fax | 956-389-1984
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Provider Business Mailing Address
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Address Line | 2101 PEASE ST EAST TOWER
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City | HARLINGEN
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State | TX
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Zip | 78550-8307
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Country | US
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Telephone | 956-389-6898
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Fax | 956-389-1984
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Authorized Official
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Title or Position | OUTPATIENT PHARMACY SUPERVISOR
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Name | JACK AYOUB
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Credential | RPH
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Telephone | 956-389-6898
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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 | 13564
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License Number State | TX
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