Organization Active NPI

Charter Way Pharmacy

  • Pharmacy
  • Stockton, CA
National Provider Identifier
1013078187
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
Legal business name
CHARTER WAY PHARMACY
Practice address
201 W Charter Wy
Stockton, CA 95206
Phone
(209) 466-2223
NPI assigned
Dec 13, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Louis Magnasco, PHARMD
Title
Vice President
Phone
(209) 466-0411

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X Primary

Addresses

Primary practice location

201 W Charter Wy
Stockton, CA 95206

Mailing address

201 W Charter Wy
Stockton, CA 95206
Phone (209) 466-2223

Other identifiers 1

IdentifierTypeStateIssuer
PHY20560MedicaidCA

National Provider Directory

National Provider Directory
Tax ID family
Charter Way Pharmacy3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

NPI Registry JSON

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

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1013078187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 W CHARTER WY",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "95206",
            "telephone_number": "209-466-2223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 W CHARTER WY",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "95206",
            "telephone_number": "209-466-2223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARTER WAY PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MAGNASCO",
        "authorized_official_first_name": "LOUIS",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "209-466-0411",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PHY20560",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Stockton, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.