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General NPI Number Information
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NPI Number | 1770950339
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Entity Type | Organization
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Legal Business Name | RGV COMPOUNDING PHARMACY
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Dates
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Enumeration Date | 08/29/2015
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Last Update Date | 07/18/2022
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Provider Practice Location Address
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Address Line | 5460 PAREDES LINE RD STE 199
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City | BROWNSVILLE
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State | TX
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Zip | 78526-9742
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Country | US
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Telephone | 956-621-0228
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Fax | 956-621-0668
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Provider Business Mailing Address
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Address Line | 100 UPTOWN AVE # 110-B
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City | BROWNSVILLE
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State | TX
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Zip | 78520-7559
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Country | US
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Telephone | 956-544-0237
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Fax | 956-544-0239
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | JOEL BENITEZ
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Credential |
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Telephone | 956-544-0237
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 #2
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Taxonomy Code | 333600000X
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Taxonomy Name | 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 | 30157
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License Number State | TX
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