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NPI Code Detail

MEDICARE: MANUEL HERNANDEZ JR. PHARMACIST

MEDICARE:   MANUEL  HERNANDEZ JR. PHARMACIST
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist21349TX

General Provider Information

NPI Number : 1134496706
Entity Type Code : Individual
Provider Name (Legal Business Name) : MANUEL HERNANDEZ JR. PHARMACIST
Provider Business Mailing Address
First Line : 8050 N MESA ST
Second Line :
City : EL PASO
State : TX
Zip : 79932-1645
Country : US
Telephone Number : 915-585-0491
Fax Number : 915-587-8763
Provider Business Practice Location Address
First Line : 8050 N MESA ST
Second Line :
City : EL PASO
State : TX
Zip : 79932-1645
Country : US
Telephone Number : 915-585-0491
Fax Number : 915-587-8763
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/25/2011
Last Update Date : 11/25/2011

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