Neeley, Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PHA212400 Issued in CA

Legal business name

NEELEY, INC

Doing business as

North Lake Medical Pharmacy

Practice address

5136 Hill Rd E
Lakeport, CA 95453-6300

Phone

(707) 263-6192

Fax

(707) 263-7839

NPI assigned

Jul 28, 2006

Last updated

Dec 9, 2021By 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

Cindy Ricetti

Title

Pharmacy Tech/Mamager

Phone

(707) 263-6192

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• North Lake Medical Pharmacy Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Tax ID family

Neeley 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.

• Neeley, Inc

  dba North Lake Medical Pharmacy LTC

  • Long Term Care Pharmacy
  • Lakeport, CA
  • NPI 1407603236
  NPD tax ID

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.

• Kyla Neeley, PHARMD

  • Pharmacist
  • Lakeport, CA
  • NPI 1710258439
  NPD
• Michael Lee Murrray, R.PH

  • Pharmacist
  • Lakeport, CA
  • NPI 1942579578
  NPD (past)

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

{
    "created_epoch": "1154044800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1639008000000",
    "number": "1013921881",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5136 HILL RD E",
            "city": "LAKEPORT",
            "state": "CA",
            "postal_code": "954536300",
            "telephone_number": "707-263-6192",
            "fax_number": "707-263-7839"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5136 HILL RD E",
            "city": "LAKEPORT",
            "state": "CA",
            "postal_code": "954536300",
            "telephone_number": "707-263-6192",
            "fax_number": "707-263-7839"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEELEY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-28",
        "last_updated": "2021-12-09",
        "certification_date": "2021-12-09",
        "status": "A",
        "authorized_official_last_name": "RICETTI",
        "authorized_official_first_name": "CINDY",
        "authorized_official_title_or_position": "PHARMACY TECH/MAMAGER",
        "authorized_official_telephone_number": "707-263-6192"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CA",
            "license": "PHA212400",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PHY57297",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "North Lake Medical Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Darcene Melaac Munir, M.D.
• Heather Murray, RN, IBCLC
• Michael Lee Murrray, R.PH
• Neeley Clinical Services Inc
• Neeley Family, Inc (North Lake Medical Pharmacy #2)
• Neeley, Inc (North Lake Medical Pharmacy LTC)
• Kyla Neeley, PHARMD
• James F Neighbors, RPH
• Maryanne Nersesyan, DDS
• Chelsea Newton

• Community/Retail Pharmacy in Lakeport, CA
• Providers in Lakeport, 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 Dec 9, 2021; 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.