Provider Demographics
NPI:1992819882
Name:Q PHARMACY INC
Entity type:Organization
Organization Name:Q PHARMACY INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CARLOS
Authorized Official - Middle Name:R
Authorized Official - Last Name:TAMI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-489-4931
Mailing Address - Street 1:14100 NACOGDOCHES RD
Mailing Address - Street 2:STE 116
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78247-1903
Mailing Address - Country:US
Mailing Address - Phone:210-491-8136
Mailing Address - Fax:210-590-6959
Practice Address - Street 1:14100 NACOGDOCHES RD
Practice Address - Street 2:STE 116
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78247-1903
Practice Address - Country:US
Practice Address - Phone:210-491-8136
Practice Address - Fax:210-590-6959
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-18
Last Update Date:2008-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
3336C0003X, 3336M0003X
TX250893336S0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336M0003XSuppliersPharmacyManaged Care Organization Pharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
4541529OtherOTHER ID NUMBER-COMMERCIAL NUMBER