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General NPI Number Information
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NPI Number | 1861532368
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Entity Type | Organization
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Legal Business Name | TIGUA PHARMACY INC
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Dates
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Enumeration Date | 02/07/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 8269 N LOOP DR
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City | EL PASO
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State | TX
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Zip | 79907-4234
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Country | US
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Telephone | 915-590-2800
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Fax | 915-590-3693
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Provider Business Mailing Address
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Address Line | 8269 N LOOP DR
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City | EL PASO
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State | TX
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Zip | 79907-4234
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Country | US
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Telephone | 915-590-2800
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Fax | 915-590-3693
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Authorized Official
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Title or Position | OWNER (PIC )
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Name | YOHANNES BEREHANE
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Credential | RPH
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Telephone | 915-590-2800
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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 | 19194
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License Number State | TX
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