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Organization
ST. MARIE CLINIC, P.A.
Active
Organization
ST. MARIE CLINIC, P.A.
Active
Other names
St. Marie Clinic, P.A. Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EDUARDO CARRILLO MD (CEO/OWNER)
(956) 585-7401
Entity
Organization
Contact information
Practice address
305 E EXPRESSWAY 83, MISSION, TX 78572-5560
(956) 585-2009
(956) 583-5833
Mailing address
305 E EXPRESSWAY 83, MISSION, TX 78572-5560
(956) 585-7401
(956) 580-1788
Taxonomy
Speciality
Code
Description
License number
State
3336C0002X
Clinic Pharmacy
Primary
45-37380
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
145560
VENDOR DRUG NUMBER
TX
01
—
45-37380
NCPDP NUMBER
TX
Enumeration date
10/02/2006
Last updated
08/14/2008
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