| NPI | 1184931040 |
|---|---|
| Doing Business As | FRED'S PHARMACY #614 |
| Entity Type | Organization |
| Authorized Contact | SANTOS GONZALEZ Owner / Corp. President 956-542-4003 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: TX 27105) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| 333600000X Pharmacy | |
| 3336C0004X Pharmacy, Compounding Pharmacy | |
| 3336H0001X Pharmacy, Home Infusion Therapy Pharmacy | |
| Enumeration Date | 2010-09-13 |
| Last Update Date | 2010-10-22 |