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FOX DRUG STORE INC NPI 1427041185


NPI Information

NPI: 1427041185
Provider Name: FOX DRUG STORE INC

Doing Business As: SUNNYSIDE PHARMACY

Classification: Pharmacist - 183500000X
Entity Type: Organization

CLIA Number: 05D2200485

Address:
1939 HIGH ST
SELMA, CA
ZIP 93662
Phone: (559) 896-1645
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FOX DRUG STORE INC is a pharmacist in Selma, CA. The provider is an individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care. FOX DRUG STORE INC NPI is 1427041185. The provider is registered as an organization entity type.
The provider Is Doing Business As Sunnyside Pharmacy.

The provider's business location address is:

1939 HIGH ST
SELMA, CA
ZIP 93662-510
Phone: (559) 896-1645
Fax: (559) 896-3266

The provider's authorized official is Lunny Ronnie Jung .
The authorized official title is Ceo and has the following contact phone number (559) 896-1645.

The CLIA number assigned to this NPI record is 05D2200485 - pharmacy with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/29/2005 and was last updated on 10/18/2011.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1332B00000XDurable Medical Equipment & Medical SuppliesPHY43450CALIFORNIANo
2332BC3200XDurable Medical Equipment & Medical SuppliesCustomized EquipmentPHY43450CALIFORNIANo
3332BN1400XDurable Medical Equipment & Medical SuppliesNursing Facility SuppliesPHY43450CALIFORNIANo
4332BP3500XDurable Medical Equipment & Medical SuppliesParenteral & Enteral NutritionPHY43450CALIFORNIANo
5333600000XPharmacyPHY43450CALIFORNIANo
61835N1003XPharmacistNutrition Support27764CALIFORNIANo
7183500000XPharmacist27764CALIFORNIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1PHY43450MEDICAIDCALIFORNIA
25162340001MEDICARE NSCCALIFORNIA
35162340001MEDICARE ID-TYPE UNSPECIFIEDCALIFORNIACMS BILLING
46571480001MEDICARE NSCCALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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