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DAVILA PHARMACY INC. NPI 1205819885


NPI Information

NPI: 1205819885
Provider Name: DAVILA PHARMACY, INC.
Classification: Pharmacy - 333600000X
Entity Type: Organization

CLIA Number: 45D0970781

Address:
1423 GUADALUPE ST
SUITE 108
SAN ANTONIO, TX
ZIP 78207
Phone: (210) 226-5293
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DAVILA PHARMACY, INC. is a pharmacy in San Antonio, TX. The provider is a facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located. DAVILA PHARMACY, INC. NPI is 1205819885. The provider is registered as an organization entity type.

The provider's business location address is:

1423 GUADALUPE ST
SUITE 108
SAN ANTONIO, TX
ZIP 78207-527
Phone: (210) 226-5293
Fax: (210) 224-9257

The provider's authorized official is Rudy Davila .
The authorized official title is Vice President Owner and has the following contact phone number (210) 226-5293.

The CLIA number assigned to this NPI record is 45D0970781 - pharmacy with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/28/2005 and was last updated on 12/4/2012.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
13336S0011XPharmacySpecialty Pharmacy01055TEXASNo
2333600000XPharmacy01055TEXASYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
10380320001MEDICARE ID-TYPE UNSPECIFIEDTEXAS
21255943401OTHERTEXASCSHCN
3013612901MEDICAIDTEXAS
4125943402MEDICAIDTEXAS
5125943403MEDICAIDTEXAS
6079060201OTHERTEXASCSHCN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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