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GREEN BROTHERS PHARMACY INC NPI 1619905221


NPI Information

NPI: 1619905221
Provider Name: GREEN BROTHERS PHARMACY, INC

Doing Business As: GREEN BROTHERS PHARMACY INC

Classification: Pharmacy - 3336C0003X
Entity Type: Organization

Specialization: Community/Retail Pharmacy

Address:
1617 N CALIFORNIA ST
STOCKTON, CA
ZIP 95204
Phone: (209) 948-6435
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GREEN BROTHERS PHARMACY, INC is a community/retail pharmacy pharmacy in Stockton, CA. The provider is a pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. GREEN BROTHERS PHARMACY, INC NPI is 1619905221. The provider is registered as an organization entity type.
The provider Is Doing Business As Green Brothers Pharmacy Inc.

The provider's business location address is:

1617 N CALIFORNIA ST
STOCKTON, CA
ZIP 95204-117
Phone: (209) 948-6435
Fax: (209) 235-0241

The provider's authorized official is Edward Rogan .
The authorized official title is Manager and has the following contact phone number (209) 948-6435.

The enumeration date for this NPI number is 6/30/2006 and was last updated on 4/15/2011.


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
1333600000XPharmacyNo
23336C0003XPharmacyCommunity/Retail PharmacyPHY17863CALIFORNIAYes

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
10421180002MEDICARE NSCCALIFORNIA
20526915OTHERNCPDP PROVIDER IDENTIFICATION NUMBER
3PHA178630MEDICAIDCALIFORNIA

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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