St Marie Clinic PA Pharmacy

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

26174 Issued in TX

Legal business name

ST MARIE CLINIC PA PHARMACY

Doing business as

St Marie Clinic PA Pharmacy

Practice address

10900 N 103Rd St
Mission, TX 78573-0979

Phone

(956) 432-0194

Fax

(956) 432-0196

NPI assigned

Sep 8, 2008

Last updated

Feb 11, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Eduardo Carrillo

Title

President

Phone

(956) 585-7401

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• St Marie Clinic PA Pharmacy Doing business as

Tax ID family

St Marie Clinic PA3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

• St Marie Clinic PA

  • Pediatric Adolescent Medicine Physician
  • Mission, TX
  • NPI 1336274380
  NPD tax ID
• St. Marie Clinic, P.a. Pharmacy

  • Community/Retail Pharmacy
  • Edinburg, TX
  • NPI 1689804551
  NPD tax ID

Locations

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

{
    "created_epoch": "1220832000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1234310400000",
    "number": "1396993986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10900 N 103RD ST",
            "city": "MISSION",
            "state": "TX",
            "postal_code": "785730979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10900 N 103RD ST",
            "city": "MISSION",
            "state": "TX",
            "postal_code": "785730979",
            "telephone_number": "956-432-0194",
            "fax_number": "956-432-0196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST MARIE CLINIC PA PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-08",
        "last_updated": "2009-02-11",
        "status": "A",
        "authorized_official_last_name": "CARRILLO",
        "authorized_official_first_name": "EDUARDO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "956-585-7401"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "TX",
            "license": "26174",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "4549486",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St Marie Clinic PA Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Melinda Mae St Bernard, LPC
• St Marie Clinic P a
• St Marie Clinic P a
• St Marie Clinic PA
• St Marie Clinic PA
• St Marie Home Health LLC
• St Teresa Clinic PA
• St. Marie Clinic, P.a. (St. Marie Clinic, P.A. Pharmacy)
• St. Marie Clinic, P.a.
• Starr DME & Pharmacy Inc. (Starr Pharmacy #2)

• Community/Retail Pharmacy in Mission, TX
• Providers in Mission, TX by specialty
• Community/Retail Pharmacy in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2009; 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.