| Medicine Shoppe | |
|
205 W Us Highway 77 San Benito TX 78586-5143 | |
| (956) 399-1411 | |
| (956) 399-2401 |
| Full Name | Medicine Shoppe |
|---|---|
| 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 |
|---|---|
| Medicine Shoppe 205 W Us Highway 77 San Benito TX 78586-5143 Ph: (956) 399-1411 | Medicine Shoppe 205 W Us Highway 77 San Benito TX 78586-5143 Ph: (956) 399-1411 |
| NPI Number | 1255443164 |
|---|---|
| Provider Enumeration Date | 08/31/2006 |
| Last Update Date | 12/04/2024 |
| Certification Date | 12/04/2024 |
| Medicare PECOS PAC ID | 6204221245 |
|---|---|
| Medicare Enrollment ID | O20220309003037 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255443164 | NPI | - | NPPES |
| 4551784 | Other | OTHER ID NUMBER-COMMERCIAL NUMBER | |
| 141674 | Medicaid | TX | |
| 1710428 | Medicaid | TX | |
| 1255443164 | Other | TX | NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | () | Secondary |
| 333600000X | Pharmacy | 04776 (Texas) | Secondary |
| 3336C0003X | Pharmacy - Community/retail Pharmacy | () | Primary |
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