PENASQUITOS PHARMACY (NPI# 1568473155) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568473155 |
| Entity Type | Organization |
| Organization Name | PENASQUITOS PHARMACY |
| Other Organization Name | PENASQUITOS PHARMACY INC |
| Practice Address |
9917 Carmel Mountain Rd San Diego CA 92129-2813 |
| Practice Telephone | 8584842880 |
| Enumeration Date | 2006-08-10 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | RICHARD BURDENHOLZER (OWNER PHARMACIST) |
| Authorized Official Telephone | 8584842880 |
| Authorized Official Credential | RPH |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 333600000X | Pharmacy | PHY32769 | CA | Suppliers |
| X | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OTHER ID NUMBER-COMMERCIAL NUMBER | 0570110 | 01 | |
| CA | PHA327690 | 05 |
| Other Name | Type Code |
|---|---|
| PENASQUITOS PHARMACY INC | Doing Business As Name - Organization |
| Street Address |
9917 CARMEL MOUNTAIN RD |
| City | SAN DIEGO |
| State | CA |
| Zip Code | 92129-2813 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053836718 | Emily Anne Haven | Physical Therapist | 9351 Vervain Street, San Diego, CA 92129 | 2017-08-03 |
| 1366802944 | Katie Nguyen | Pharmacist | 13014 Lemon Pine Ct, San Diego, CA 92129 | 2016-02-25 |
| 1588029912 | Larry Labossiere II | Registered Nurse | 8195 Torrey Gardens Place, San Diego, CA 92129 | 2015-12-30 |
| 1184034746 | Jim S Chang | Dentist | 12798 Rancho Penasquitos Blvd # 1, San Diego, CA 92129 | 2014-05-05 |
| 1841627593 | John Richard Codington | Dentist | 9728 Carmel Mountain Ro., Suite B, San Diego, CA 92129 | 2013-09-26 |
| 1407298284 | Michael Saade | Dentist | 9310 Carmel Mountain Rd Ste A, San Diego, CA 92129 | 2013-07-22 |
| 1801141338 | Satnick Chiropractic | Acupuncturist | 12880 Rancho Penasquitos Blvd, Steb, San Diego, CA 92129 | 2012-07-20 |
| 1558627463 | Louise Jeremia Gatchalian Angelo | Student in an Organized Health Care Education/Training Program | 9434 Twin Trails Dr, Unit 201, San Diego, CA 92129 | 2012-04-04 |
| 1093965477 | Joanne C Vargas-velasco | Dentist | 12580 Ragweed Street, San Diego, CA 92129 | 2008-09-23 |
| 1699960377 | Robert B Case | Social Worker | 12602 Spindletop Rd, San Diego, CA 92129 | 2007-09-06 |
| Find all providers in zip 92129 | ||||
| Taxonomy Code | 333600000X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located. |
| 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: added definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114528940 | Kaiser Foundation Health Plan Inc | Pharmacy | 4647 Zion Ave Fl4, Rm 4825, San Diego, CA 92120-2507 | 2020-11-06 |
| 1891394128 | Scriptdash Inc | Pharmacy | 4240 Kearny Mesa Rd Ste 107, San Diego, CA 92111-3769 | 2020-10-19 |
| 1720607112 | Kaiser Foundation Health Plan Inc | Pharmacy | 6911 Convoy Ct Fl 1 Rm 1501, San Diego, CA 92111-1014 | 2020-04-15 |
| 1275169005 | Corrections and Rehabilitation | Pharmacy | 481 Alta Road, Facility E, Facility Support Building, Room A161, San Diego, CA 92179 | 2020-03-12 |
| 1942772272 | Rising Star Holdings LLC | Pharmacy | 500 S Dr Ee Dunlap Hwy Ste C, San Diego, TX 78384-3415 | 2018-12-27 |
| 1326551003 | Theotokos, LLC | Pharmacy | 5550 Carmel Mountain Rd Ste 111, San Diego, CA 92130 | 2017-11-16 |
| 1700245099 | Naval Medical Center San Diego | Pharmacy | Mcas Miramar Exchange Pharmacy, Bldg 2660, San Diego, CA 92126 | 2016-02-16 |
| 1912362377 | Dt Pharmacy Corporation | Pharmacy | 5507 El Cajon Blvd # E, San Diego, CA 92115-3624 | 2015-12-29 |
| 1649600487 | Aids Healthcare Foundation | Pharmacy | 3940 Fourth Avenue, Suite 150, San Diego, CA 92103-7193 | 2013-11-14 |
| 1144574260 | Medpilot Pharmacy Inc. | Pharmacy | 9323 Chesapeake Dr, Suite #c1, San Diego, CA 92123-1044 | 2012-10-29 |
| Find all providers in SAN DIEGO | ||||
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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.