| |
205 W Us Highway 77 San Benito TX 78586-5143 | |
(956) 399-1411 | |
(956) 399-2401 |
Full Name | |
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Speciality | Pharmacy |
Location | 205 W Us Highway 77, San Benito, Texas |
Authorized Official Name and Position | Thomas Amadeo Garza (RPH) |
Authorized Official Contact | 9563991411 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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205 W Us Highway 77 San Benito TX 78586-5143 Ph: (956) 399-1411 | 205 W Us Highway 77 San Benito TX 78586-5143 Ph: (956) 399-1411 |
NPI Number | 1255443164 |
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Provider Enumeration Date | 08/31/2006 |
Last Update Date | 12/04/2024 |
Medicare PECOS PAC ID | 2860602810 |
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Medicare Enrollment ID | O20200910002888 |
Identifier | Type | State | Issuer |
---|---|---|---|
1255443164 | NPI | - | NPPES |
4551784 | Other | OTHER ID NUMBER-COMMERCIAL NUMBER | |
141674 | Medicaid | TX | |
1710428 | Medicaid | TX | |
1255443164 | Other | TX | NPI |
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