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General NPI Number Information
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NPI Number | 1912851858
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Entity Type | Organization
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Legal Business Name | PHARMA LOGISTICS, LLC DBA FIESTA RX#4
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Dates
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Enumeration Date | 02/26/2026
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Last Update Date | 02/26/2026
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Provider Practice Location Address
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Address Line | 21 SPURS LN STE SL-160
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City | SAN ANTONIO
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State | TX
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Zip | 78240-1692
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Country | US
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Telephone | 210-201-4580
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Fax | 210-201-7442
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Provider Business Mailing Address
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Address Line | 942 W CRAIG PL
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City | SAN ANTONIO
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State | TX
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Zip | 78201-5772
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Country | US
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Telephone | 210-385-8013
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Fax |
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Authorized Official
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Title or Position | GENERAL MANAGER
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Name | JODY WELCHANS
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Credential | RPH
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Telephone | 210-385-8013
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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 |
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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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