Medishack, Inc.

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

MEDISHACK, INC.

Doing business as

MediShack Pharmacy

Practice address

1901 Sunny Crest Dr
Fullerton, CA 92835-3626

Phone

(323) 206-0971

NPI assigned

Oct 27, 2021

Organization subpart

No

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

Authorized official

Name

Michael M Shaker

Title

President/Ceo

Phone

(323) 206-0971

Specialties & licenses 1

Addresses

Other names 1

• MediShack Pharmacy Doing business as

Locations

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

{
    "created_epoch": "1635292800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1641859200000",
    "number": "1033873823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1901 SUNNY CREST DR",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928353626",
            "telephone_number": "323-206-0971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 SUNNY CREST DR",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928353626",
            "telephone_number": "323-206-0971"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDISHACK, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-27",
        "last_updated": "2022-01-11",
        "certification_date": "2022-01-11",
        "status": "A",
        "authorized_official_last_name": "SHAKER",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "323-206-0971"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MediShack Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Alina Medina
• Jaymi Noelle Medina
• Jazmine Sabrina Medina
• Michael Alexander Medina, PA
• Vanessa Medina
• Janet Medrano Razo
• Gregory Meeker
• Imani Meeks
• Tiffany Roush Mehner
• Shilpa J. Mehta, MD

• Community/Retail Pharmacy in Fullerton, CA
• Providers in Fullerton, 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 Jan 11, 2022; 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.