Provider Demographics
NPI:1699761452
Name:J & A MEDICAL CENTER PHARMACY LLC
Entity type:Organization
Organization Name:J & A MEDICAL CENTER PHARMACY LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER/MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:AL
Authorized Official - Middle Name:J
Authorized Official - Last Name:CHAPA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-717-3839
Mailing Address - Street 1:6703 MCPHERSON RD
Mailing Address - Street 2:
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78041-6404
Mailing Address - Country:US
Mailing Address - Phone:956-717-3839
Mailing Address - Fax:956-717-2749
Practice Address - Street 1:6703 MCPHERSON RD
Practice Address - Street 2:
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78041-6404
Practice Address - Country:US
Practice Address - Phone:956-717-3839
Practice Address - Fax:956-717-2749
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-26
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1000361332BP3500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX143914Medicaid
TX4588147OtherNABP NUMBER
TX111330001Medicaid
TX111330001Medicaid
TX4588147OtherNABP NUMBER