Active NPI
DRG Pharmacy LLC
Doing business as Hueneme Family Pharmacy
- Specialty Pharmacy
- Oxnard, CA
National Provider Identifier
1023296449
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialty Pharmacy
- Legal business name
- DRG PHARMACY LLC
- Doing business as
- Hueneme Family Pharmacy
- Practice address
- 401 N Lombard St Ste a
Oxnard, CA 93030-8032 - Phone
- (805) 488-8200
- Fax
- (805) 488-8211
- NPI assigned
- Feb 7, 2008
- Last updated
- Aug 16, 2021
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Jeffrey T White
- Title
- Ceo/Owner
- Phone
- (805) 981-1171
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Retail Pharmacy | 3336C0003X | 53764 | CA | |
| Home Infusion Therapy Pharmacy | 3336H0001X | NU | ||
| Specialty Pharmacy | 3336S0011X | NU | Primary |
Addresses
Primary practice location
401 N Lombard St Ste a
Oxnard, CA 93030-8032
Mailing address
401 N Lombard St Ste a
Oxnard, CA 93030-8032
Phone (805) 488-8200
Other identifiers 10
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023296449 | Medicaid | CA | |
| 5630478 | Other | NCPDP PROVIDER IDENTIFICATION NUMBER | |
| 1023296449 | Medicaid | MI | |
| 1023296449 | Medicaid | MN | |
| 553516 | Medicaid | AZ | |
| 1023296449 | Medicaid | ID | |
| 6032569 | Medicaid | WA | |
| 1023296449 | Medicaid | MT | |
| 1023296449 | Medicaid | NV | |
| 2973859 | Medicaid | OH |
Other names 1
- HUENEME FAMILY PHARMACY
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20090604000174 | CA | Part B Supplier - Pharmacy | 8224188768 | Practice locations: Oxnard, CA |
National Provider Directory
National Provider Directory- Tax ID family
- DRG Pharmacy LLC
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
Locations
248 E Scott St
Port Hueneme, CA 93041
Phone (805) 488-8200
261 E Port Hueneme Rd
Port Hueneme, CA 93041
Practitioners & affiliated clinicians
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.
-
- Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
- Oxnard, CA
- NPI 1689267940
-
- Pharmacist
- Port Hueneme, CA
- NPI 1962813733
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1202342400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1629072000000",
"number": "1023296449",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "401 N LOMBARD ST STE A",
"city": "OXNARD",
"state": "CA",
"postal_code": "930308032",
"telephone_number": "805-488-8200",
"fax_number": "805-488-8211"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "401 N LOMBARD ST STE A",
"city": "OXNARD",
"state": "CA",
"postal_code": "930308032",
"telephone_number": "805-488-8200",
"fax_number": "805-488-8211"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "DRG PHARMACY LLC",
"organizational_subpart": "NO",
"enumeration_date": "2008-02-07",
"last_updated": "2021-08-16",
"certification_date": "2021-08-16",
"status": "A",
"authorized_official_last_name": "WHITE",
"authorized_official_first_name": "JEFFREY",
"authorized_official_middle_name": "T",
"authorized_official_title_or_position": "CEO/OWNER",
"authorized_official_telephone_number": "805-981-1171"
},
"taxonomies": [
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": "CA",
"license": "53764",
"primary": false
},
{
"code": "3336H0001X",
"taxonomy_group": "",
"desc": "Pharmacy, Home Infusion Therapy Pharmacy",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "3336S0011X",
"taxonomy_group": "",
"desc": "Pharmacy, Specialty Pharmacy",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1023296449",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
"identifier": "5630478",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1023296449",
"state": "MI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1023296449",
"state": "MN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "553516",
"state": "AZ"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1023296449",
"state": "ID"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "6032569",
"state": "WA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1023296449",
"state": "MT"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1023296449",
"state": "NV"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2973859",
"state": "OH"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "HUENEME FAMILY PHARMACY",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "HUENEME FAMILY PHARMACY",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Oxnard, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 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.