Organization
PECOS STREET PHARMACY, INC.
Active
Other names
Medi-Mart Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
BRYAN T ABERNATHY (PRESIDENT)
(325) 949-4636
Entity
Organization
Contact information
Practice address
2102 PECOS ST, STE 13, SAN ANGELO, TX 76901-3061
(325) 949-5381
(325) 942-9997
Mailing address
2102 PECOS ST, SAN ANGELO, TX 76901-3061
(325) 949-5381
(325) 942-9997
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
13819
TX
3336L0003X
Long Term Care Pharmacy
Primary
13819
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
350004
—
TX
01
—
4586307
NABP NUMBER
TX
Enumeration date
05/27/2005
Last updated
07/11/2019
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
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