| NPI | 1679588214 |
|---|---|
| Doing Business As | PORT AVENUE DRUG STORE |
| Entity Type | Organization |
| Authorized Contact | DIANE SANCHEZ President 361-883-8551 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: TX 24047) |
| Enumeration Date | 2006-07-30 |
| Last Update Date | 2010-02-16 |