Clinic Pharmacies III LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

53768 Issued in CA

Legal business name

CLINIC PHARMACIES III LLC

Doing business as

Western Sierra Pharmacy

Practice address

844 Old Tunnel Rd
Grass Valley, CA 95945-8524

Phone

(530) 273-0182

Fax

(530) 273-0698

NPI assigned

Jun 18, 2015

Last updated

Sep 15, 2022By the provider in NPPES

Organization subpart

Yes

Parent organization

CLINIC PHARMACIES III LLCAs reported in NPPES

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

Authorized official

Name

Michael Brown

Title

Vice President, Managed Services

Phone

(281) 749-4764

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Western Sierra Pharmacy Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

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

• Clinic Pharmacies III LLC

  dba Camarena Pharmacy

  • Community/Retail Pharmacy
  • Madera, CA
  • NPI 1891177580

  O20250414001748

  Same enrollment

Tax ID family

Clinic Pharmacies III LLC2 organizations share this tax ID, including this one

Part of

Clinic Pharmacies III LLC

Other organizations with this tax ID 1

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

• Clinic Pharmacies III LLC

  dba Camarena Pharmacy

  • Community/Retail Pharmacy
  • Madera, CA
  • NPI 1891177580
  NPD tax ID

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

{
    "created_epoch": "1434585600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1663200000000",
    "number": "1063894756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13651 DUBLIN CT",
            "city": "STAFFORD",
            "state": "TX",
            "postal_code": "774774317",
            "telephone_number": "281-749-4000",
            "fax_number": "614-652-0326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "844 OLD TUNNEL RD",
            "city": "GRASS VALLEY",
            "state": "CA",
            "postal_code": "959458524",
            "telephone_number": "530-273-0182",
            "fax_number": "530-273-0698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLINIC PHARMACIES III LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CLINIC PHARMACIES III LLC",
        "enumeration_date": "2015-06-18",
        "last_updated": "2022-09-15",
        "certification_date": "2022-09-13",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "VICE PRESIDENT, MANAGED SERVICES",
        "authorized_official_telephone_number": "281-749-4764"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CA",
            "license": "53768",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2154184",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Western Sierra Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Western Sierra Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Elizabeth M. Claydon, M.D.
• Marc Timothy Claydon, DPM
• Susan Dyer Claydon, N.P.
• Alicia Mercy Anne Clayton
• Amy Elisabeth Clement, PA-C
• Wendell David Clove, D.D.S.
• Crystal Leah Clune, LMFT 139013
• Montana Summer Clute
• Chelsea Leigh Cockman
• Lindsey Jade Coen

• Community/Retail Pharmacy in Grass Valley, CA
• Providers in Grass Valley, 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 Sep 15, 2022; 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.