MODERNHEALTH HOLDINGS INC (NPI# 1508094558) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508094558 |
| Entity Type | Organization |
| Organization Name | MODERNHEALTH HOLDINGS INC |
| Other Organization Name | MODERN HEALTH PHARMACY - SD |
| Practice Address |
13220 Evening Creek Dr S Ste 110 San Diego CA 92128-4103 |
| Mailing Address |
110 E Huntington Dr Monrovia CA 91016-3415 |
| Practice Telephone | 8586683350 |
| Practice Fax Number | 8586683352 |
| Mailing Telephone | 8586683350 |
| Mailing Fax Number | 8586683352 |
| Enumeration Date | 2009-06-29 |
| Last Update Date | 2017-04-19 |
| Authorized Official Name | SHANNON CHOU (DIRECTOR, BUSINESS OPERATIONS) |
| Authorized Official Telephone | 6269321721 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 333600000X | Pharmacy | Suppliers | ||
| Y | 3336L0003X |
Pharmacy Specialization: Long Term Care Pharmacy |
PHY51002 | CA | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2121362 | 01 | |
| CA | 1508094558 | 05 |
| Other Name | Type Code |
|---|---|
| Modern Health Pharmacy - SD | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861495863 | Modernhealth Holdings Inc | Pharmacy | 110 E Huntington Dr, Monrovia, CA 91016-3415 | 2005-05-23 |
| Street Address |
13220 EVENING CREEK DR S STE 110 |
| City | SAN DIEGO |
| State | CA |
| Zip Code | 92128-4103 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619988102 | Med-plus Pharmacy Inc | Pharmacy | 13220 Evening Creek Dr S, San Diego, CA 92128 | 2006-08-10 |
| 1992861595 | Real World Enterprises | Pharmacy | 13220 Evening Creek Dr S, Suite 110, San Diego, CA 92128-4103 | 2006-12-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518585371 | Alicia Ford | Behavior Technician | 1170 Bernardo Plaza Court, Suite 350, San Diego, CA 92128 | 2020-07-08 |
| 1164087573 | Madeleine White | Dietitian, Registered | 16685 W Bernardo Dr, Suite 121, San Diego, CA 92128 | 2019-05-01 |
| 1053807677 | Joele Ghosn | Speech-Language Pathologist | 11838 Bernardo Plaza Ct #110, San Diego, CA 92128 | 2018-07-06 |
| 1376034348 | Eddie Reginald Burston II | In Home Supportive Care | 12727 Camino Emparrado, San Diego, CA 92128 | 2018-05-24 |
| 1336659218 | Ryan Fong | Physician Assistant | 15004 Innovation Drive (s97), San Diego, CA 92128 | 2017-10-05 |
| 1508316191 | Araceli Flores | Behavioral Analyst | 15737 Innovation Dr, Suite 200, San Diego, CA 92128 | 2016-10-07 |
| 1003283961 | Katherine Dishner | Hearing Instrument Specialist | 16766 Bernardo Center Dr Ste 206, San Diego, CA 92128 | 2015-08-27 |
| 1205212586 | Mobilia Dmd Inc. | Point of Service | 12405 Rancho Bernardo Rd., San Diego, CA 92128 | 2015-08-10 |
| 1346623634 | Angela Christine Storck-petersen | Dietitian, Registered | 11768 Caminito Corriente, San Diego, CA 92128 | 2015-07-04 |
| 1134526874 | Breeana Rose Lancaster | Speech-Language Pathologist | 11838 Bernardo Plaza Ct. Suite 110, Kids Therapy Associates, San Diego, CA 92128 | 2014-11-24 |
| Find all providers in zip 92128 | ||||
| Taxonomy Code | 3336L0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Long Term Care Pharmacy |
| A pharmacy that dispenses medicinal preparations delivered to patients residing within an intermediate or skilled nursing facility, including intermediate care facilities for mentally retarded, hospice, assisted living facilities, group homes, and other forms of congregate living arrangements. |
| 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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| 1932332343 | Rezcare Pharmacy Inc. | Pharmacy | 3821 Calle Fortunada Ste D, San Diego, CA 92123-4811 | 2009-09-01 |
| 1588734123 | Evergreen Pharmaceutical of California, Inc. | Pharmacy | 5601 Oberlin Dr, Suite 124, San Diego, CA 92121-3747 | 2006-11-09 |
| 1295367761 | Hillcrest Pharmacy Inc | Pharmacy | 120 University Ave, San Diego, CA 92103-3007 | 2020-02-12 |
| 1427499128 | Rty Pharmaceutical Inc | Pharmacy | 5222 Balboa Ave, San Diego, CA 92117-6904 | 2013-07-10 |
| 1992861595 | Real World Enterprises | Pharmacy | 13220 Evening Creek Dr S, Suite 110, San Diego, CA 92128-4103 | 2006-12-28 |
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| 1538718838 | Xpress Med Pharmacy Inc | Pharmacy | 16929 Bushard St, Fountain Valley, CA 92708-2819 | 2019-09-09 |
| 1275180580 | Proscript Pharmacy Inc | Pharmacy | 7462 N Fresno St, Fresno, CA 93720-2404 | 2019-08-21 |
| Find all providers with the same taxonomy | ||||
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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.