Med Matrix Pharmacy, Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

MED MATRIX PHARMACY, INC

Doing business as

Med Care Pharmacy

Practice address

161 Thunder Dr
Vista, CA 92083-6016

Phone

(760) 758-7650

Fax

(760) 758-8228

NPI assigned

Jan 19, 2006

Organization subpart

No

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

Authorized official

Name

Connie K Dao

Title

Owner

Phone

(760) 758-7650

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Med Care Pharmacy Doing business as

Medicare fee-for-service enrollment

Enrolled in CA2 enrollments

Enrollment records 2

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• BBN Pharmacy Inc

  dba Spring Park Pharmacy

  • Community/Retail Pharmacy
  • Long Beach, CA
  • NPI 1902811524

  6901212919

  Same PAC ID
• Med Matrix Pharmacy, Inc

  • Pharmacy
  • Vista, CA
  • NPI 1538805056

  6204201460

  Same PAC ID

Tax ID family

Med Matrix Pharmacy Inc4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

• Med Matrix Pharmacy, Inc

  • Pharmacy
  • Vista, CA
  • NPI 1538805056
  NPD tax ID
• Med Matrix Pharmacy, Inc

  • Long Term Care Pharmacy
  • Vista, CA
  • NPI 1700716149
  NPD tax ID
• Med Matrix Pharmacy, Inc

  • Pharmacist
  • Vista, CA
  • NPI 1902593585
  NPD tax ID

Locations

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

{
    "created_epoch": "1137628800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730764800000",
    "number": "1093795577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "161 THUNDER DR STE 100",
            "city": "VISTA",
            "state": "CA",
            "postal_code": "920836051",
            "telephone_number": "760-758-7650",
            "fax_number": "760-758-8228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "161 THUNDER DR",
            "city": "VISTA",
            "state": "CA",
            "postal_code": "920836016",
            "telephone_number": "760-758-7650",
            "fax_number": "760-758-8228"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "130 Cedar Rd",
            "address_purpose": "LOCATION",
            "city": "Vista",
            "state": "CA",
            "postal_code": "920835102",
            "country_code": "US",
            "telephone_number": "760-630-8806",
            "fax_number": "760-630-2406",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MED MATRIX PHARMACY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-19",
        "last_updated": "2024-11-05",
        "certification_date": "2024-11-05",
        "status": "A",
        "authorized_official_last_name": "DAO",
        "authorized_official_first_name": "CONNIE",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "760-758-7650"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2127529",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Med Care Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Lauren Severs McNeely, M.D.
• William Earl McNicholl
• Melissa McNutt, CCC SLP
• Jennie McOmber
• Jasmine Marie McPhatter
• Med Matrix Pharmacy, Inc
• Med Matrix Pharmacy, Inc
• Med Matrix Pharmacy, Inc
• Medical Group of North County, Inc.
• Gabriela Medina

• Community/Retail Pharmacy in Vista, CA
• Providers in Vista, 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 Nov 5, 2024; 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.