MEDICARE: DR. DELORA PINEDA B.S., PHARM D, RPH

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
1	183500000X	Pharmacist	50585	TX

General Provider Information

NPI Number	:	1174806160
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DELORA PINEDA B.S., PHARM D, RPH

Provider Business Mailing Address
First Line	:	8045 N LOOP DR
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79915-3227
Country	:	US
Telephone Number	:	915-592-5849
Fax Number	:	915-592-5412

Provider Business Practice Location Address
First Line	:	8045 N LOOP DR
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79915-3227
Country	:	US
Telephone Number	:	915-592-5849
Fax Number	:	915-592-5412

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/26/2011
Last Update Date	:	09/26/2011

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