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Contact Information

EDELMIRO TELLEZ
2515 CASTROVILLE RD
SAN ANTONIO, TX78237-3359
 Phone: 210-432-2361
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Community/Retail Pharmacy

3336C0003X 58 Medical Supply Company with Pharmacist
 

Compounding Pharmacy

3336C0004X 58 Medical Supply Company with Pharmacist
 

Long Term Care Pharmacy

3336L0003X 58 Medical Supply Company with Pharmacist
 

Managed Care Organization Pharmacy

3336M0003X 58 Medical Supply Company with Pharmacist
 

Pharmacy Technician

183700000X
Indicates primary specialty

NPI Profile & details for

NPI Number 1871179259
Entity Organization
Organization subpart 1 Not specified
Enumeration date 03/24/2021
Last updated 03/24/2021 - About 5 years ago
Identifiers n/a
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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