Active NPI
Los Ebanos Pharmacy,LLC
- Pharmacy
- Brownsville, TX
National Provider Identifier
1376546937
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacy
- License
- 02302
- Legal business name
- LOS EBANOS PHARMACY,LLC
- Practice address
- 1134 E Los Ebanos Blvd
Brownsville, TX 78520-8730 - Phone
- (956) 542-8542
- Fax
- (956) 542-0044
- NPI assigned
- May 27, 2005
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Robert J De Lachica, R.PH.
- Title
- Owner
- Phone
- (956) 542-8542
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | 02302 | TX | Primary |
Addresses
Primary practice location
1134 E Los Ebanos Blvd
Brownsville, TX 78520-8730
Mailing address
1134 E Los Ebanos Blvd
Brownsville, TX 78520-8730
Phone (956) 542-8542
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4503810 | Other | TX | NCPDP NUMBER |
| 141943 | Medicaid | TX |
National Provider Directory
National Provider Directory- Tax ID family
- Los Ebanos Pharmacy Northllc
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Pharmacy
- Brownsville, TX
- NPI 1275539678
Locations
1134 E Los Ebanos Blvd
Brownsville, TX 78520
Phone (956) 542-8542
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1117152000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1221782400000",
"number": "1376546937",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1134 E LOS EBANOS BLVD",
"city": "BROWNSVILLE",
"state": "TX",
"postal_code": "785208730",
"telephone_number": "956-542-8542",
"fax_number": "956-542-0044"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1134 E LOS EBANOS BLVD",
"city": "BROWNSVILLE",
"state": "TX",
"postal_code": "785208730",
"telephone_number": "956-542-8542",
"fax_number": "956-542-0044"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "LOS EBANOS PHARMACY,LLC",
"organizational_subpart": "NO",
"enumeration_date": "2005-05-27",
"last_updated": "2008-09-19",
"status": "A",
"authorized_official_last_name": "DE LACHICA",
"authorized_official_first_name": "ROBERT",
"authorized_official_middle_name": "J",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "956-542-8542",
"authorized_official_name_prefix": "Mr.",
"authorized_official_credential": "R.PH."
},
"taxonomies": [
{
"code": "333600000X",
"taxonomy_group": "",
"desc": "Pharmacy",
"state": "TX",
"license": "02302",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NCPDP NUMBER",
"identifier": "4503810",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "141943",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Brownsville, TX
- Lorenzo R Pelly MD
- Laura Ileana Lorenzo, M.S., CCC-SLP
- Los Ebanos Family Dentistry
- Los Ebanos Home Health Care, Inc
- Los Ebanos Pharmacy North,LLC
- Los Girasoles Home Care Agency, LLP
- Los Olivos Home Care LLC
- Moses Michael Losoya
- Carlos H. Loubriel-Velez, M.D.
- Lovely Skin Medical Aesthetics and Wellness Center PLLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.