Full Name | |
---|---|
Speciality | Pharmacy |
Location | 708 N Grant St, Roma, Texas |
Authorized Official Name and Position | Jesus Rios (PHARMACIST/ OWNER) |
Authorized Official Contact | 9568491811 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Po Box 2945 Roma TX 78584-2945 Ph: (956) 849-1811 | 708 N Grant St Roma TX 78584-5310 Ph: (956) 849-1811 |
NPI Number | 1396714903 |
---|---|
Provider Enumeration Date | 03/16/2006 |
Last Update Date | 01/24/2025 |
Medicare PECOS PAC ID | 1254549405 |
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Medicare Enrollment ID | O20100930072826 |
Identifier | Type | State | Issuer |
---|---|---|---|
1396714903 | NPI | - | NPPES |
148205 | Medicaid | TX | |
16551101-01 | Medicaid | TX | |
23167 | Other | TX | TX ST BOARD OF PHARMACY |
16551102-02 | Medicaid | TX |
Nuestra Clinica Del Valle Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2891 E Grant St, Roma, TX 78584 Phone: 956-849-2100 Fax: 956-787-8915 | |