FORTUNA PHARMACY INC NPI 1881806610

NPI Details

FORTUNA PHARMACY INC is a community/retail pharmacy pharmacy in Fortuna, 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. FORTUNA PHARMACY INC NPI is 1881806610. The provider is registered as an organization entity type.
The provider Is Doing Business As Green's Fortuna Pharmacy.

The provider's business location address is:

1058 MAIN ST
FORTUNA, CA
ZIP 95540-009
Phone: (707) 725-4431
Fax: (707) 725-2671

The provider's authorized official is Robert Earl Johnson .
The authorized official title is President and has the following contact phone number (707) 725-4431.

The CLIA number assigned to this NPI record is 05D2316599 - pharmacy with a certificate type of Certificate of Waiver.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

• Administration of influenza virus vaccine (HCPCS:G0008)
• Adm sarscov2 50mcg/0.25mlbst (HCPCS:0064A)
• Influenza vaccine split virus, preservative free (HCPCS:90662)
• Influenza vaccine, quadrivalent, 0.5 ml dosage (HCPCS:90688)
• Fee covid-19 vac 13 res (HCPCS:0124A)
• Fee covid-19 vac 14 res (HCPCS:0134A)
• Administration of pneumococcal vaccine (HCPCS:G0009)
• Influenza vaccine, quadrivalent, preservative free, 0.5 ml dosage (HCPCS:90686)
• Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use (HCPCS:90677)

The enumeration date for this NPI number is 5/4/2007 and was last updated on 8/22/2020.

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:

Other Identifiers

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