Peccio Medi-Mart Plus L.L.C

Primary specialty

Exclusive Provider OrganizationTaxonomy code 302F00000X

License

26858 Issued in TX

Legal business name

PECCIO MEDI-MART PLUS L.L.C

Doing business as

PECCIO PHARMACY PLUS #II

Practice address

5615 Richmond Ave
Suite 165
Houston, TX 77057-6327

Phone

(713) 780-7600

Fax

(713) 780-7603

NPI assigned

Apr 5, 2010

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Sunny R. Nwaobi, PHARMACIST

Title

Pharmacist-in-Charge

Phone

(713) 780-7600

Specialties & licenses 1

Addresses

Other names 1

• PECCIO PHARMACY PLUS #II Doing business as

Tax ID family

Peccio Medi-Mart Plus L L C2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Peccio Medi-Mart Plus L L C

  • Community/Retail Pharmacy
  • Beaumont, TX
  • NPI 1801026505
  NPD tax ID

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1270425600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1270425600000",
    "number": "1164747903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5615 RICHMOND AVE",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770576327",
            "telephone_number": "713-780-7600",
            "fax_number": "713-780-7603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5615 RICHMOND AVE",
            "address_2": "SUITE 165",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770576327",
            "telephone_number": "713-780-7600",
            "fax_number": "713-780-7603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PECCIO MEDI-MART PLUS L.L.C",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-05",
        "last_updated": "2010-04-05",
        "status": "A",
        "authorized_official_last_name": "NWAOBI",
        "authorized_official_first_name": "SUNNY",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "PHARMACIST-IN-CHARGE",
        "authorized_official_telephone_number": "713-780-7600",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PHARMACIST"
    },
    "taxonomies": [
        {
            "code": "302F00000X",
            "taxonomy_group": "",
            "desc": "Exclusive Provider Organization",
            "state": "TX",
            "license": "26858",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PECCIO PHARMACY PLUS #II",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Exclusive Provider Organization in Houston, TX
• Providers in Houston, TX by specialty
• Exclusive Provider Organization in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.