Suburban Drug Co a Corp

Primary specialty

Long Term Care PharmacyTaxonomy code 3336L0003X

License

PHY55814 Issued in CA

Legal business name

SUBURBAN DRUG CO A CORP

Doing business as

Los Coyotes Drug

Practice address

10572 Calle Lee Ste 138
Los Alamitos, CA 90720-8541

Phone

(562) 420-1480

Fax

(866) 859-1508

NPI assigned

Nov 14, 2006

Last updated

Feb 19, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Jerrold Lee Rosenbaum, PHARM. D.

Title

President

Phone

(562) 420-1480

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• LOS COYOTES DRUG Doing business as

Locations

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

{
    "created_epoch": "1163462400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1518998400000",
    "number": "1144392226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10572 CALLE LEE STE 138",
            "city": "LOS ALAMITOS",
            "state": "CA",
            "postal_code": "907208541",
            "telephone_number": "562-420-1480",
            "fax_number": "866-859-1508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10572 CALLE LEE STE 138",
            "city": "LOS ALAMITOS",
            "state": "CA",
            "postal_code": "907208541",
            "telephone_number": "562-420-1480",
            "fax_number": "866-859-1508"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUBURBAN DRUG CO A CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-14",
        "last_updated": "2018-02-19",
        "status": "A",
        "authorized_official_last_name": "ROSENBAUM",
        "authorized_official_first_name": "JERROLD",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "562-420-1480",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHARM. D."
    },
    "taxonomies": [
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "CA",
            "license": "PHY55814",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP#",
            "identifier": "0510190",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PHY55814",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LOS COYOTES DRUG",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "LOS COYOTES DRUG",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Katelyn Amanda Stults, NP
• Edy Stumpf, MFT
• Mallory Anne Stuparich, M.D.
• Anna Sturz
• Maricruz Suber, FNP-C
• Leslie Sugita, MA, OTR/L
• Mathew Byron Sullivan, PT
• Sunmed Medical Systems LLC
• Samantha Swift
• Jake Patrick Sylwanowicz, DDS

• Long Term Care Pharmacy in Los Alamitos, CA
• Providers in Los Alamitos, CA by specialty
• Long Term Care Pharmacy in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2018; 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.