Mother Lode Drug Company

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PHY31052 Issued in CA

Legal business name

MOTHER LODE DRUG COMPANY

Practice address

5034 Coakley Circle Dr.
Mariposa, CA 95338-2099

Phone

(209) 742-7600

Fax

(209) 742-7500

NPI assigned

Feb 21, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Richard A. Radanovich, RPHNPI 1811286586

Title

Pharmacist

Phone

(209) 742-7600

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

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

• Richard Anthony Radanovich, RPH

  • Pharmacist
  • Mariposa, CA
  • NPI 1811286586
  NPD (past) Authorized official

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

{
    "created_epoch": "1172016000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1083759625",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2099",
            "city": "MARIPOSA",
            "state": "CA",
            "postal_code": "953382099",
            "telephone_number": "209-742-7600",
            "fax_number": "209-742-7500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5034 COAKLEY CIRCLE DR.",
            "city": "MARIPOSA",
            "state": "CA",
            "postal_code": "953382099",
            "telephone_number": "209-742-7600",
            "fax_number": "209-742-7500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOTHER LODE DRUG COMPANY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-21",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "RADANOVICH",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "PHARMACIST",
        "authorized_official_telephone_number": "209-742-7600",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CA",
            "license": "PHY31052",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PHA310520",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jennifer E Moore, LCSW
• Paula A Moore
• Sunday Lynn Moore
• Hope Ellen Morton
• Charles B Mosher Jr., MD
• Mountain Mental Health
• Linda Diane Murdock
• Anne-Marie Norton
• Ashley Olejniczak, AMFT, APCC
• Amy Olson, M.S.

• Community/Retail Pharmacy in Mariposa, CA
• Providers in Mariposa, 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 Aug 22, 2020; 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.