Republic Pharmacy Co., Inc.

Primary specialty

PharmacyTaxonomy code 333600000X

License

PHY694 Issued in CA

Legal business name

REPUBLIC PHARMACY CO., INC.

Practice address

704 Grant Ave
San Francisco, CA 94108-2114

Phone

(415) 982-8641

NPI assigned

Nov 11, 2005

Organization subpart

No

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

Authorized official

Name

William Wong Jr.

Title

President

Phone

(415) 982-8641

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1131667200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1104807460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "704 GRANT AVE",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941082114",
            "telephone_number": "415-982-8641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "704 GRANT AVE",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941082114",
            "telephone_number": "415-982-8641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REPUBLIC PHARMACY CO., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-11",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WONG",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "415-982-8641",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "CA",
            "license": "PHY694",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PH00A6940",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Pharmacy in San Francisco, CA
• Providers in San Francisco, CA by specialty
• 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.