Pine Drug Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

53628 Issued in CA

Legal business name

PINE DRUG INC

Practice address

618 S Main St
Santa Ana, CA 92701-5716

Phone

(714) 676-2078

Fax

(714) 676-2079

NPI assigned

Apr 2, 2015

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

John DangNPI 1225201197

Title

Pharmacy Manager

Phone

(714) 839-1267

Specialties & licenses 5

Addresses

Other identifiers 2

Other names 1

• South Main Aloha Pharmacy Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Pine Drug Inc

  • Pharmacy
  • Westminster, CA
  • NPI 1851385983

  1254451388

  Same PAC ID

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Tax ID family

Pine Drug Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Pine Drug Holdings LLC

  • Community/Retail Pharmacy
  • Orange, CA
  • NPI 1679228183
  NPD tax ID

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• John Quoc My Dang, PHARM.D.

  • Pharmacist
  • Westminster, CA
  • NPI 1225201197
  NPD (past) Authorized official
• Dan Dang, RPH

  • Pharmacist
  • Westminster, CA
  • NPI 1184899163
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1427932800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1669680000000",
    "number": "1003201328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "618 S MAIN ST",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927015716",
            "telephone_number": "714-676-2078",
            "fax_number": "714-839-5871"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "618 S MAIN ST",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927015716",
            "telephone_number": "714-676-2078",
            "fax_number": "714-676-2079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PINE DRUG INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-02",
        "last_updated": "2022-11-29",
        "certification_date": "2022-11-29",
        "status": "A",
        "authorized_official_last_name": "DANG",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "PHARMACY MANAGER",
        "authorized_official_telephone_number": "714-839-1267"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CA",
            "license": "53628",
            "primary": true
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1003201328",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2154303",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "South Main Aloha Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Rosa Maria Pina
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• Pinales DDS Dental Corp
• Santo Pinales, DDS
• Aylin Pineda
• Chantille Yolanda Pineda
• Gene Patrick Pineda, RN
• Menetzy Pineda
• Noemi Pineda

• Community/Retail Pharmacy in Santa Ana, CA
• Providers in Santa Ana, CA by specialty
• Community/Retail Pharmacy in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.