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WHITE CROSS DRUG STORE NPI 1609887199


NPI Information

NPI: 1609887199
Provider Name: WHITE CROSS DRUG STORE
Classification: Pharmacy - 3336L0003X
Entity Type: Organization

Specialization: Long Term Care Pharmacy

Address:
4074 FAIRMOUNT AVE
SAN DIEGO, CA
ZIP 92105
Phone: (619) 284-1141
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WHITE CROSS DRUG STORE is a long term care pharmacy pharmacy in San Diego, CA. The provider is 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. WHITE CROSS DRUG STORE NPI is 1609887199. The provider is registered as an organization entity type.

The provider's business location address is:

4074 FAIRMOUNT AVE
SAN DIEGO, CA
ZIP 92105-608
Phone: (619) 284-1141
Fax: (619) 284-0503

The provider's authorized official is Max Atiya .
The authorized official title is Owner and has the following contact phone number (619) 284-1141.

The enumeration date for this NPI number is 8/10/2006 and was last updated on 8/31/2007.


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
1333600000XPharmacyNo
23336L0003XPharmacyLong Term Care PharmacyPHY45196CALIFORNIAYes

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
11251020001MEDICARE NSC
20595681OTHEROTHER ID NUMBER-COMMERCIAL NUMBER
30595681OTHEROTHER ID NUMBER
4PHA451960MEDICAIDCALIFORNIA

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: 4/28/2024

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