Organization
PECCIO MEDI-MART PLUS L L C
Active
Other names
Peccio Pharmacy Plus
Organization subpart
No
Provider details
NPI number
Authorized official
SUNNY NWAOBI (PHARMACIST-IN-CHARGE)
(409) 454-1513
Entity
Organization
Contact information
Practice address
3035 COLLEGE ST STE B, BEAUMONT, TX 77701-4641
(409) 813-1717
(409) 813-1724
Mailing address
PO BOX 21376, BEAUMONT, TX 77720-1376
(409) 813-1717
(409) 813-1724
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
26549
TX
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
146683
—
TX
01
—
2121151
PK
—
Enumeration date
07/16/2009
Last updated
04/24/2023
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