TDSM Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PHY 49856 Issued in CA

Legal business name

TDSM INC

Doing business as

Vida Drug Store & Pharmacy

Practice address

437 N Euclid Ave
Suite B
Ontario, CA 91762-3456

Phone

(909) 983-0999

Fax

(909) 983-0888

NPI assigned

Oct 6, 2006

Organization subpart

No

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

Authorized official

Name

Nariman Eshak

Title

Ceo

Phone

(909) 983-0999

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• VIDA DRUG STORE & PHARMACY Doing business as

Locations

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

{
    "created_epoch": "1160092800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1670889600000",
    "number": "1093802514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "437 N EUCLID AVE",
            "address_2": "SUITE B",
            "city": "ONTARIO",
            "state": "CA",
            "postal_code": "917623456",
            "telephone_number": "909-983-0999",
            "fax_number": "909-983-0888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "437 N EUCLID AVE",
            "address_2": "SUITE B",
            "city": "ONTARIO",
            "state": "CA",
            "postal_code": "917623456",
            "telephone_number": "909-983-0999",
            "fax_number": "909-983-0888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TDSM INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-06",
        "last_updated": "2022-12-13",
        "certification_date": "2022-09-02",
        "status": "A",
        "authorized_official_last_name": "ESHAK",
        "authorized_official_first_name": "NARIMAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "909-983-0999"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CA",
            "license": "PHY 49856",
            "primary": true
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1093802514",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "VIDA DRUG STORE & PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "VIDA DRUG STORE & PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Retail Pharmacy in Ontario, CA
• Providers in Ontario, 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 Dec 13, 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.