| NPI | 1114146420 |
|---|---|
| Doing Business As | DE VINE PHARMACY |
| Entity Type | Organization |
| Authorized Contact | IFEYINWA E Owner/President 915-845-7600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: TX 25508) |
| Additional Taxonomies | 333600000X Pharmacy |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| Enumeration Date | 2007-04-25 |
| Last Update Date | 2010-06-30 |