Provider Demographics
NPI:1902568165
Name:CULEBRA RX PHARMACY
Entity Type:Organization
Organization Name:CULEBRA RX PHARMACY
Other - Org Name:CULEBRA RX PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PIC
Authorized Official - Prefix:
Authorized Official - First Name:NIKUL
Authorized Official - Middle Name:
Authorized Official - Last Name:DHADUK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-886-8686
Mailing Address - Street 1:9793 CULEBRA RD STE 101
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78251-3750
Mailing Address - Country:US
Mailing Address - Phone:210-886-8686
Mailing Address - Fax:210-568-6812
Practice Address - Street 1:9793 CULEBRA RD STE 101
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78251-3750
Practice Address - Country:US
Practice Address - Phone:210-886-8686
Practice Address - Fax:210-568-6812
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-06
Last Update Date:2021-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy