St. Marie Clinic, P.a. Pharmacy

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

26174 Issued in TX

Legal business name

ST. MARIE CLINIC, P.A. PHARMACY

Practice address

1905 E. Monte Cristo Road Ste. C
Edinburg, TX 78541-0333

Phone

(956) 287-1831

Fax

(956) 287-7832

NPI assigned

Jul 24, 2009

Last updated

Jul 24, 2009By the provider in NPPES

Organization subpart

Yes

Parent organization

ST. MARIE CLINIC, P.A.As reported in NPPES

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

Authorized official

Name

Eduardo Carrillo, MDNPI 1316962566

Title

Ceo

Phone

(956) 585-7401

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

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

Part of

St Marie Clinic PA

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 PA Pharmacy

  • Community/Retail Pharmacy
  • Mission, TX
  • NPI 1396993986
  NPD tax ID

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Eduardo Carrillo, MD

  • Family Medicine Physician
  • Mission, TX
  • NPI 1316962566
  NPD (past) Authorized official

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

{
    "created_epoch": "1248393600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1248393600000",
    "number": "1689804551",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "305 E EXPRESSWAY 83",
            "city": "MISSION",
            "state": "TX",
            "postal_code": "785725560",
            "telephone_number": "956-585-7401",
            "fax_number": "956-583-5833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1905 E. MONTE CRISTO ROAD STE. C",
            "city": "EDINBURG",
            "state": "TX",
            "postal_code": "785410333",
            "telephone_number": "956-287-1831",
            "fax_number": "956-287-7832"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. MARIE CLINIC, P.A. PHARMACY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ST. MARIE CLINIC, P.A.",
        "enumeration_date": "2009-07-24",
        "last_updated": "2009-07-24",
        "status": "A",
        "authorized_official_last_name": "CARRILLO",
        "authorized_official_first_name": "EDUARDO",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "956-585-7401",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "TX",
            "license": "26174",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE NUMBER",
            "identifier": "26174",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Robbie Jo Stamaria
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• Cecil Stehr, DC

• Community/Retail Pharmacy in Edinburg, TX
• Providers in Edinburg, 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 Jul 24, 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.