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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