Active NPI
La Hacienda Pharmacy Inc
- Community/Retail Pharmacy
- San Diego, TX
National Provider Identifier
1821133455
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- License
- 2869
- Legal business name
- LA HACIENDA PHARMACY INC
- Doing business as
- LA HACIENDA PHARMACY INC
- Practice address
- 213 S Dr E E Dunlap St
San Diego, TX 78384-2801 - Phone
- (361) 279-3869
- Fax
- (361) 279-3182
- NPI assigned
- Feb 21, 2007
- 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
- Adolfo Montemayor, RPH
- Title
- Owner President
- Phone
- (361) 279-3869
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | |||
| Community/Retail Pharmacy | 3336C0003X | 2869 | TX | Primary |
Addresses
Primary practice location
213 S Dr E E Dunlap St
San Diego, TX 78384-2801
Mailing address
213 S Dr Eedunlap St
San Diego, TX 78384-2801
Phone (361) 279-3869
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 370011 | Medicaid | TX | |
| 4531201 | Other | NCPDP PROVIDER IDENTIFICATION NUMBER |
Other names 1
- LA HACIENDA PHARMACY INC
National Provider Directory
National Provider DirectoryLocations
213 S Dunlap St
San Diego, TX 78384
Phone (361) 279-3869
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172016000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1334793600000",
"number": "1821133455",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "213 S DR EEDUNLAP ST",
"city": "SAN DIEGO",
"state": "TX",
"postal_code": "783842801",
"telephone_number": "361-279-3869",
"fax_number": "361-279-3182"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "213 S DR E E DUNLAP ST",
"city": "SAN DIEGO",
"state": "TX",
"postal_code": "783842801",
"telephone_number": "361-279-3869",
"fax_number": "361-279-3182"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "LA HACIENDA PHARMACY INC",
"organizational_subpart": "NO",
"enumeration_date": "2007-02-21",
"last_updated": "2012-04-19",
"status": "A",
"authorized_official_last_name": "MONTEMAYOR",
"authorized_official_first_name": "ADOLFO",
"authorized_official_title_or_position": "OWNER PRESIDENT",
"authorized_official_telephone_number": "361-279-3869",
"authorized_official_credential": "RPH"
},
"taxonomies": [
{
"code": "333600000X",
"taxonomy_group": "",
"desc": "Pharmacy",
"state": null,
"license": null,
"primary": false
},
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": "TX",
"license": "2869",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "370011",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
"identifier": "4531201",
"state": null
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "LA HACIENDA PHARMACY INC",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in San Diego, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.