PROFESSIONAL VILLAGE PHARMACY, INC. (NPI# 1639262256) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639262256 |
| Entity Type | Organization |
| Organization Name | PROFESSIONAL VILLAGE PHARMACY, INC. |
| Practice Address |
1701 Professional Dr Sacramento CA 95825-2104 |
| Practice Telephone | 9164833455 |
| Practice Fax Number | 9164836745 |
| Mailing Telephone | 9164833455 |
| Mailing Fax Number | 9164836745 |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. JOHN CLARKE RICHARDS IV (SECRETARY/CFO) |
| Authorized Official Telephone | 9164833455 |
| Authorized Official Credential | PHARM.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | PHA469970 | 05 | |
| CA | NABP | 0573077 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427145309 | Professional Village Pharmacy, Inc. | Durable Medical Equipment & Medical Supplies | 1701 Professional Dr, Sacramento, CA 95825-2104 | 2006-10-10 |
| Street Address |
1701 PROFESSIONAL DR |
| City | SACRAMENTO |
| State | CA |
| Zip Code | 95825-2104 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023197563 | John Clarke Richards Iv | Pharmacist | 1701 Professional Dr, Sacramento, CA 95825-2104 | 2006-11-03 |
| 1427145309 | Professional Village Pharmacy, Inc. | Durable Medical Equipment & Medical Supplies | 1701 Professional Dr, Sacramento, CA 95825-2104 | 2006-10-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528667854 | Sarah Claudio | Case Manager/Care Coordinator | 650 Howe Ave # 400-b, Sacramento, CA 95825 | 2020-10-19 |
| 1962009308 | Andrea Isabel Morales | Behavior Technician | 333 University Avenue, Suite 200, Sacramento, CA 95825 | 2020-10-08 |
| 1942810510 | Melissa Marlene Lowndes | Occupational Therapist | 1337 Howe Ave Unit 107, Sacramento, CA 95825 | 2020-08-07 |
| 1780294827 | Travis Elliott Peppers | Case Manager/Care Coordinator | 650 Howe Ave Suite 400-b, 650 Howe Ave Suite 400-b, Sacramento, CA 95825 | 2020-08-04 |
| 1154950327 | Hallie Wenz | Behavior Technician | 333 University Ave Suite #200, Sacramento, CA 95825 | 2020-04-08 |
| 1679105456 | Dr. Page Hudson Dental Corporation | Dentist | 1580 Howe Avenue, Suite A, Sacramento, CA 95825 | 2020-02-10 |
| 1710517891 | Amelia Garnica | Community/Behavioral Health | 720 Howe Avenue, Suite 102, Sacamento, CA 95825 | 2020-01-17 |
| 1427697374 | Anthony Barnes | Social Worker | 2008 Morse Avenue, Commons Building, Sacramento, CA 95825 | 2019-12-24 |
| 1528604519 | Mental Health America of Northern California | Community/Behavioral Health | 720 Howe Ave., Suite 102, Cacramento, CA 95825 | 2019-11-25 |
| 1164068144 | Mental Health America of Northern California | Community/Behavioral Health | 720 Howe Ave. Suite, 102, Sacramento, CA 95825 | 2019-11-25 |
| Find all providers in zip 95825 | ||||
| Taxonomy Code | 332B00000X |
| Grouping | Suppliers |
| Classification | Durable Medical Equipment & Medical Supplies |
| A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient’s use in the home and that are usable for an extended period of time. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154942811 | Sacvans Mobility, Inc. | Durable Medical Equipment & Medical Supplies | 5821 Florin Perkins Rd Ste 1, Sacramento, CA 95828-1032 | 2020-05-04 |
| 1578120697 | Fix Pain Dme LLC | Durable Medical Equipment & Medical Supplies | 836 57th St, Sacramento, CA 95819-3327 | 2019-05-23 |
| 1437618394 | Sirius Scripts, Inc. | Durable Medical Equipment & Medical Supplies | 5880 Stockton Blvd Ste C, Sacramento, CA 95824-3055 | 2019-03-19 |
| 1720543846 | Innovative Dme LLC | Durable Medical Equipment & Medical Supplies | 3325 Longview Dr, Sacramento, CA 95821-7103 | 2019-02-02 |
| 1760956494 | Sacramento Home Medical LLC | Durable Medical Equipment & Medical Supplies | 4811 Chippendale Dr Ste 601, Sacramento, CA 95841-2553 | 2019-01-16 |
| 1871063420 | Otto Bock Orthopedic Services LLC | Durable Medical Equipment & Medical Supplies | 3800 Watt Avenue Suite 151, Sacramento, CA 95821 | 2018-11-27 |
| 1467928200 | Safeway Inc | Durable Medical Equipment & Medical Supplies | 3680 Crocker Dr, Ste 100, Sacramento, CA 95818 | 2018-10-19 |
| 1558836635 | Dme Next LLC | Durable Medical Equipment & Medical Supplies | 1257 Fulton Ave Apt 6, Sacramento, CA 95825-7319 | 2018-10-04 |
| 1356823850 | Dme Medical Care LLC | Durable Medical Equipment & Medical Supplies | 1257 Fulton Ave, Sacramento, CA 95825-7318 | 2018-08-30 |
| 1922504877 | Fast Practice Innovations LLC | Durable Medical Equipment & Medical Supplies | 1257 Fulton Ave Apt 21, Sacramento, CA 95825-7320 | 2018-03-31 |
| Find all providers in SACRAMENTO | ||||
| City | SACRAMENTO |
| Zip Code | 95825 |
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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.