NPIMap

Organization Active NPI

North East Medical Services

Doing business as NEMS-San Bruno Pharmacy

  • Community/Retail Pharmacy
  • San Francisco, CA
National Provider Identifier
1013241199
Registry record updated Oct 1, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
50033 Issued in CA
Legal business name
NORTH EAST MEDICAL SERVICES
Doing business as
NEMS-San Bruno Pharmacy
Practice address
2574 San Bruno Ave
San Francisco, CA 94134-1505
Phone
(415) 352-5091
Fax
(415) 352-5092
NPI assigned
Sep 23, 2009
Organization subpart
Yes
Parent organization
NORTH EAST MEDICAL SERVICESAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 1, 2012

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

Authorized official

Name
Dr. Eddie Chan, PHARM.D.
Title
President & Ceo
Phone
(415) 391-9686

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 50033 CA Primary

Addresses

Primary practice location

2574 San Bruno Ave
San Francisco, CA 94134-1505

Mailing address

1520 Stockton St
San Francisco, CA 94133-3354
Phone (415) 391-9686

Other identifiers 1

IdentifierTypeStateIssuer
1013241199MedicaidCA

Other names 1

  • NEMS-San Bruno Pharmacy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20201026001202 CA Part B Supplier - Mass Immunization (Roster Biller Only) 4284520529 7 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Daly City, CA; San Francisco, CA; San Jose, CA

Other NPIs on the same Medicare enrollment 7

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
North East Medical Services57 organizations share this tax ID, including this one
Part of
North East Medical Services

Organizations with this tax ID in the same state 14

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1253664000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1349049600000",
    "number": "1013241199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1520 STOCKTON ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941333354",
            "telephone_number": "415-391-9686",
            "fax_number": "415-433-4726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2574 SAN BRUNO AVE",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941341505",
            "telephone_number": "415-352-5091",
            "fax_number": "415-352-5092"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH EAST MEDICAL SERVICES",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NORTH EAST MEDICAL SERVICES",
        "enumeration_date": "2009-09-23",
        "last_updated": "2012-10-01",
        "status": "A",
        "authorized_official_last_name": "CHAN",
        "authorized_official_first_name": "EDDIE",
        "authorized_official_title_or_position": "PRESIDENT & CEO",
        "authorized_official_telephone_number": "415-391-9686",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHARM.D."
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CA",
            "license": "50033",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1013241199",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NEMS-San Bruno Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Francisco, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.