OLIVEHURST DRUG STORE INC (NPI# 1255464871) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255464871 |
| Entity Type | Organization |
| Organization Name | OLIVEHURST DRUG STORE INC |
| Other Organization Name | OLIVEHURST DRUG STORE |
| Practice Address |
4897 Olivehurst Ave Olivehurst CA 95961-4225 |
| Mailing Address |
4897 Olivehurst Ave Po Box 720 Olivehurst CA 95961-4225 |
| Practice Telephone | 5307435451 |
| Practice Fax Number | 5307433713 |
| Mailing Telephone | 5307435431 |
| Mailing Fax Number | 5307433731 |
| Enumeration Date | 2007-03-13 |
| Last Update Date | 2017-03-28 |
| Authorized Official Name | HECTOR CAMACHO (OWNER/PIC) |
| Authorized Official Telephone | 5307435451 |
| Authorized Official Credential | RPH |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 333600000X | Pharmacy | Suppliers | ||
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
PHY48813 | CA | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2066990 | 01 |
| Other Name | Type Code |
|---|---|
| OLIVEHURST DRUG STORE | Doing Business As Name - Organization |
| Street Address |
4897 OLIVEHURST AVE |
| City | OLIVEHURST |
| State | CA |
| Zip Code | 95961-4225 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225596315 | Shelby Marie Mclaughlin | Counselor | 471 Century Park Drive B, Yuba City, CA 95961 | 2019-03-07 |
| 1780125583 | Elia Moreno Thomas | Counselor | 1754 Skinner Ave, Olivehurst, CA 95961 | 2017-03-13 |
| 1356652549 | Hyesung Han | Pharmacist | 5075 Olivehurst Ave, Olivehurst, CA 95961 | 2010-06-23 |
| 1225283195 | Pao Choua Lor | Driver | 4552 Meadow Wy, Olivehurst, CA 95961 | 2008-11-19 |
| 1235385725 | Thera Lynn Hampton | Specialist | 1345 Lady Fern St., Plumas Lake, CA 95961 | 2008-08-15 |
| 1841444049 | Thrifty Payless Inc | Durable Medical Equipment & Medical Supplies | 5075 Olivehurst Avenue, Olivehurst, CA 95961-4023 | 2008-11-14 |
| 1699382192 | Ryan Sauer | Pharmacist | 5075 Olivehurst Ave, Olivehurst, CA 95961-4023 | 2020-09-28 |
| 1649721648 | Vandana Chaudhari | Pharmacist | 5075 Olivehurst Ave, Olivehurst, CA 95961-4023 | 2016-10-14 |
| 1679880850 | Tilak Baviskar | Pharmacist | 5075 Olivehurst Ave, Olivehurst, CA 95961-4023 | 2010-09-08 |
| 1801829296 | Ampla Health | Clinic/Center | 4941 Olivehurst Ave., Olivehurst, CA 95961-4225 | 2006-07-08 |
| Find all providers in zip 95961 | ||||
| Taxonomy Code | 3336C0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Community/Retail Pharmacy |
| 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. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
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| 1689271066 | Innova Pharmacy Iv | Pharmacy | 4815 Watt Ave Ste B101, North Highlands, CA 95660-5108 | 2020-10-08 |
| 1114524683 | Bear Valley Pharmacy | Pharmacy | 17003 Bear Valley Rd Ste B, Hesperia, CA 92345-1420 | 2020-10-07 |
| Find all providers with the same taxonomy | ||||
| City | OLIVEHURST |
| Zip Code | 95961 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.