Organization Active NPI

Well-Care Pharmacy

  • Community/Retail Pharmacy
  • Sacramento, CA
National Provider Identifier
1124430111
Registry record updated Jan 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
WELL-CARE PHARMACY
Practice address
3645 Northgate Blvd
Suite F
Sacramento, CA 95834-1641
Phone
(916) 649-1615
Fax
(916) 649-1399
NPI assigned
May 24, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2015

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

Authorized official

Name
Mobeen Yamin, RPH
Title
Ceo
Phone
(916) 835-8986

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X Primary

Addresses

Primary practice location

3645 Northgate Blvd
Suite F
Sacramento, CA 95834-1641

Mailing address

3645 Northgate Blvd
Suite F
Sacramento, CA 95834-1641
Phone (916) 649-1615

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20141024000999 CA DME Supplier - Pharmacy 9234350869 Practice locations: Sacramento, CA

National Provider Directory

National Provider Directory
Tax ID family
Well-Care Pharmacy2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

3645 Northgate Blvd
Ste F
Sacramento, CA 95834
Phone (916) 649-1615

NPI Registry JSON

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

{
    "created_epoch": "1400889600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1421366400000",
    "number": "1124430111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3645 NORTHGATE BLVD",
            "address_2": "SUITE F",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958341641",
            "telephone_number": "916-649-1615",
            "fax_number": "916-649-1399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3645 NORTHGATE BLVD",
            "address_2": "SUITE F",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958341641",
            "telephone_number": "916-649-1615",
            "fax_number": "916-649-1399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELL-CARE PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-24",
        "last_updated": "2015-01-16",
        "status": "A",
        "authorized_official_last_name": "YAMIN",
        "authorized_official_first_name": "MOBEEN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "916-835-8986",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2015; 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.