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MEDI-MART PHARMACY
NPI 1659374379
Pharmacy - Long Term Care Pharmacy in San Angelo, TX

Active since May 27, 2005CLIA 45D2153699 · Waiver
2102 PECOS ST, STE 13, SAN ANGELO, TX 76901(325) 949-5381(325) 942-9997 Get Directions Write a Review

NPPES record last updated: July 11, 2019. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jul 11, 2019, Aug 30, 2016 (2 updates tracked since 2016).

About Medi-mart Pharmacy NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MEDI-MART PHARMACY (NPI 1659374379) is a healthcare organization registered as a long term care pharmacy in San Angelo, Texas and active in the NPI registry since May 2005. The organization holds a CLIA Waiver certificate valid through August 28, 2026 and lists Bryan T Abernathy, President, as its authorized official.

NPPES Registry Identity

NPI1659374379
Entity TypeOrganization
Primary Taxonomy3336L0003X
Legal Business NamePECOS STREET PHARMACY, INC.
Location Address2102 PECOS ST, STE 13San Angelo, TX 76901-3061
Mailing Address2102 Pecos StSan Angelo, TX 76901-3061 · (325) 949-5381 · Fax (325) 942-9997
Phone(325) 949-5381
Fax(325) 942-9997
Organization SubpartNo
Authorized OfficialBryan T AbernathyPresident · (325) 949-4636
Enumeration DateMay 27, 2005
Last NPPES UpdateJuly 11, 20192 updates tracked since enumeration
✔ NPI 1659374379 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPharmacy · Long Term Care PharmacySuppliers
Taxonomy Code3336L0003X
License✔ Licensed in TX · 13819
Definition
A pharmacy that dispenses medicinal preparations delivered to patients residing within an intermediate or skilled nursing facility, including intermediate care facilities, hospice, assisted living facilities, group homes, and other forms of congregate living arrangements.
Also ListedPharmacyTaxonomy 333600000X · License 13819 (TX)
2102 PECOS ST, San Angelo, TX 76901
Open in Google Maps ↗

Other Names 1

Doing Business AsMedi-mart Pharmacy

Other Identifiers 2

Other4586307TX · Nabp Number
Medicaid350004TX

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Medica, Moda Health Plan, Inc..Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 45D2153699

Pecos Street Pharmacy, Inc Medical Arts Pharmacy · San Angelo, TX
Active · expires Aug 28, 2026
CLIA Number45D2153699
Laboratory TypePhysician Office
Certificate Effective DateAugust 29, 2024
Certificate Expiration DateAugust 28, 2026
Laboratory DirectorBryan T. Abernathy
Laboratory Phone(325) 949-4636
Laboratory LocationPecos Street Pharmacy, Inc Medical Arts Pharmacy2102 Pecos St, San Angelo, TX 76901
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Medical Equipment Supplier Medicare DMEPOS 12

Medicare supplier enrollment and the product categories Medical Arts Pharmacy carries, from the Medicare DMEPOS supplier directory.

Medical Arts Pharmacy

DMEPOS supplier · San Angelo, TXOperated by Pecos Street Pharmacy Inc
⋮

Does not accept Medicare assignment

Medical Arts Pharmacy has not agreed to accept the Medicare-approved amount as full payment for covered equipment and supplies. Medicare patients may be charged more than the Medicare-approved amount; confirm the expected cost with the supplier before ordering.

PTAN (Medicare Supplier Number)20656847
Medicare Participant SinceJanuary 1, 1998
Supplier Location2102 Pecos StSan Angelo, TX 76901
Phone(325) 949-4636
Supplier Specialties
Certified Other Pharmacy

Medicare Product Categories

Immunosuppressive Drugs
Immunosuppressive drugs require dosage, frequency, and route of administration to prevent or treat the rejection of an organ transplant
Nebulizer Drugs
Albuterol, levalbuterol, and metaproterenol are all short-acting bronchodilators with beta-adrenergic stimulatory effect
Oral Anticancer Drugs
FDA anticancer drugs
Oral Antiemetic Drugs
FDA antiemetic drugs
Commodes, Urinals, Bedpans
Raised toilets, Drop-arm commodes, Folding commodes, Plastic urinals, Plastic bedpans, Disposable urinals
Blood Glucose Monitors/Supplies (Non-Mail Order)
Home blood glucose monitors including lancets, reagent strips, and other supplies necessary for the proper functioning of the device
Product categories are from the Medicare DMEPOS supplier directory. Contact the supplier to confirm current availability of specific items.

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MR. LARRY BLANE WILLIAMS R.PH.
Pharmacist
2102 PECOS ST, SUITE 4
SAN ANGELO, TX 76901
Tom Green County (325) 949-4636
MRS. MARY WILLIAMS EAKMAN R.PH.
Pharmacist
2102 PECOS ST, STE 13
SAN ANGELO, TX 76901
Tom Green County (325) 949-5381
MR. ALFRED LYNN TURNER R.PH.
Pharmacist
2102 PECOS ST, SUITE 4
SAN ANGELO, TX 76901
Tom Green County (325) 949-4636
MR. DOYLE DOUGLAS EAKMAN R.PH.
Pharmacist
2102 PECOS ST, STE 4
SAN ANGELO, TX 76901
Tom Green County (325) 949-4636
JAMES C WOMACK MD PA
General Practice
2102 PECOS ST, SUITE 7
SAN ANGELO, TX 76901
Tom Green County (325) 949-4766

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Pecos Street Pharmacy, Inc.'s NPI number?

The NPI number for Pecos Street Pharmacy, Inc. is 1659374379. It was assigned to this organization in the NPPES registry on May 27, 2005. The provider is doing business as Medi-Mart Pharmacy.

Where is Pecos Street Pharmacy, Inc. located?

Pecos Street Pharmacy, Inc. is located at 2102 Pecos St Ste 13, San Angelo, TX 76901. The listed phone number is (325) 949-5381.

What is Pecos Street Pharmacy, Inc.'s specialty?

The primary specialty registered for this NPI is Pharmacy, specializing in Long Term Care Pharmacy, with taxonomy code 3336L0003X.

Does Pecos Street Pharmacy, Inc. accept Medicare assignment for medical equipment?

No. As a Medicare medical equipment supplier, Medical Arts Pharmacy does not accept Medicare assignment for equipment and supplies, so patients may be charged more than the Medicare-approved amount. Confirm the expected cost with the supplier before ordering.

Does Pecos Street Pharmacy, Inc. hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 45D2153699) is associated with this NPI, valid through August 28, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Pecos Street Pharmacy, Inc. accept?

Health plans from Medica and Moda Health Plan, Inc. list Pecos Street Pharmacy, Inc. as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Pecos Street Pharmacy, Inc. was last updated on July 11, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.