NPIMap

Organization Active NPI

CVS

  • Pharmacist
  • Lodi, CA
National Provider Identifier
1083087761
Registry record updated Nov 3, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
40586 Issued in CA
Legal business name
CVS
Practice address
100 W Lodi Ave
Lodi, CA 95240-3517
Phone
(209) 369-3648
Fax
(209) 369-3104
NPI assigned
Nov 3, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2015

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

Authorized official

Name
Mr. Mark Tadao Tamura, PHARMDNPI 1508321894
Title
Pharmacist
Phone
(209) 712-7055

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PharmacistGroup: 193200000X MULTI-SPECIALTY GROUP 183500000X 40586 CA Primary

Addresses

Primary practice location

100 W Lodi Ave
Lodi, CA 95240-3517

Mailing address

11181 Boessow Rd
Galt, CA 95632-8321
Phone (209) 369-3648

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1446508800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1446508800000",
    "number": "1083087761",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11181 BOESSOW RD",
            "city": "GALT",
            "state": "CA",
            "postal_code": "956328321",
            "telephone_number": "209-369-3648",
            "fax_number": "209-369-3104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 W LODI AVE",
            "city": "LODI",
            "state": "CA",
            "postal_code": "952403517",
            "telephone_number": "209-369-3648",
            "fax_number": "209-369-3104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CVS",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-03",
        "last_updated": "2015-11-03",
        "status": "A",
        "authorized_official_last_name": "TAMURA",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "TADAO",
        "authorized_official_title_or_position": "PHARMACIST",
        "authorized_official_telephone_number": "209-712-7055",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "40586",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lodi, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2015; 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.