Ceres Drug Store, Inc.

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

CERES DRUG STORE, INC.

Doing business as

Ceres Drug Store

Practice address

2929 4TH St
Ceres, CA 95307-3222

Phone

(209) 537-0718

Fax

(209) 537-4252

NPI assigned

Jul 30, 2006

Last updated

Sep 18, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Derek Smernes, PHARM.D.NPI 1629532213

Title

Ceo

Phone

(209) 537-0718

Specialties & licenses 3

Addresses

Other identifiers 4

Other names 1

• CERES DRUG STORE Doing business as

Medicare fee-for-service enrollment

Enrolled in CA2 enrollments

Enrollment records 2

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

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Derek Smernes

  • Pharmacist
  • Ceres, CA
  • NPI 1629532213
  NPD Authorized official
• Justin Smernes

  • Pharmacist
  • Ceres, CA
  • NPI 1497219091
  NPD (past)

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

{
    "created_epoch": "1154217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1568764800000",
    "number": "1003821638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2929 4TH ST",
            "city": "CERES",
            "state": "CA",
            "postal_code": "953073222",
            "telephone_number": "209-537-0718",
            "fax_number": "209-537-4252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2929 4TH ST",
            "city": "CERES",
            "state": "CA",
            "postal_code": "953073222",
            "telephone_number": "209-537-0718",
            "fax_number": "209-537-4252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CERES DRUG STORE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-30",
        "last_updated": "2019-09-18",
        "status": "A",
        "authorized_official_last_name": "SMERNES",
        "authorized_official_first_name": "DEREK",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "209-537-0718",
        "authorized_official_credential": "PHARM.D."
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CA",
            "license": "PHY30773",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PHY30773",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2034704",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PHA307730",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PHY57145",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CERES DRUG STORE",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "CERES DRUG STORE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Regina Cavanah
• Renalyn Cedeno
• Ivet Ceja
• Center for Human Services (Ceres Partnership for Healthy Children)
• Center for Human Services
• Ceres Eye Care Inc a Professional Optometric Corporation
• Ceres Unified School District
• Jesus Cervantes
• Nathan Chalk
• Eliot Chang, DDS

• Community/Retail Pharmacy in Ceres, CA
• Providers in Ceres, 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 Sep 18, 2019; 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.