MEDICARE: HECTOR G. ARREDONDO

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	333600000X	Pharmacy
2	3336C0003X	Community/Retail Pharmacy	2930	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	4500472	OTHER	OTHER ID NUMBER-COMMERCIAL NUMBER
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	4500472	OTHER	OTHER ID NUMBER

General Provider Information

NPI Number	:	1679792980
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HECTOR G. ARREDONDO

Provider Business Mailing Address
First Line	:	3712 ALAMEDA AVE
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79905-2507
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3712 ALAMEDA AVE
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79905-2507
Country	:	US
Telephone Number	:	915-533-8446
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	HECTOR ARREDONDO
Credential	:	RPH
Telephone Number	:	915-533-8447

Provider Enumeration Date	:	04/25/2007
Last Update Date	:	08/12/2008

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Directions to “HECTOR G. ARREDONDO ” Practice Location

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