Peccio Medi-Mart Plus L L C

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

26549 Issued in TX

Legal business name

PECCIO MEDI-MART PLUS L L C

Practice address

3035 College St Ste B
Beaumont, TX 77701-4641

Phone

(409) 813-1717

Fax

(409) 813-1724

NPI assigned

Jul 16, 2009

Organization subpart

No

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

Authorized official

Name

Sunny Nwaobi

Title

Pharmacist-in-Charge

Phone

(409) 454-1513

Specialties & licenses 3

Addresses

Other identifiers 2

Other names 1

• Peccio Pharmacy Plus 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

  • Exclusive Provider Organization
  • Houston, TX
  • NPI 1164747903
  NPD tax ID

Locations

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

{
    "created_epoch": "1247702400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1682294400000",
    "number": "1801026505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 21376",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777201376",
            "telephone_number": "409-813-1717",
            "fax_number": "409-813-1724"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3035 COLLEGE ST STE B",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777014641",
            "telephone_number": "409-813-1717",
            "fax_number": "409-813-1724"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PECCIO MEDI-MART PLUS L L C",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-07-16",
        "last_updated": "2023-04-24",
        "certification_date": "2023-04-24",
        "status": "A",
        "authorized_official_last_name": "NWAOBI",
        "authorized_official_first_name": "SUNNY",
        "authorized_official_title_or_position": "PHARMACIST-IN-CHARGE",
        "authorized_official_telephone_number": "409-454-1513"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "TX",
            "license": "26549",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2121151",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "146683",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Peccio Pharmacy Plus",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Retail Pharmacy in Beaumont, TX
• Providers in Beaumont, 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 Apr 24, 2023; 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.