Professional Pavilion Pharmacy
LBN: Professional Pavilion Pharmacy Inc
Professional Pavilion Pharmacy is an health care organization with primary practice located at 315 N San Saba Ste 110, San Antonio TX 78207-3154. The organization recently has 2 registered licenses in different health care specialties including Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty.
Professional Pavilion Pharmacy Inc can be contacted via phone (210) 212-7455, or through Martin, Roberto via phone (210) 271-7575.
Contact Information
Primary practice address
315 N San Saba Ste 110
San Antonio TX 78207-3154
Phone: (210) 212-7455
Fax: (210) 212-6643
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Suppliers / Pharmacy | 333600000X | ||
| Suppliers / Community/Retail Pharmacy | 3336C0003X | 17417 | Texas |
Profile Details
| NPI number | 1235294661 |
|---|---|
| LBN Legal business name | Professional Pavilion Pharmacy Inc |
| DBA Doing business as | Professional Pavilion Pharmacy |
| Authorized official | Martin, Roberto Doctor of Medicine (MD) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Dec 26th, 2006 |
| Last updated | Oct 19th, 2012 - about 12 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1235294661 | NPPES |
| Other | 4599950 | NCPDP PROVIDER IDENTIFICATION NUMBER |
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