Senior Care Pharmacy Services Fairfield Inc

Primary specialty

Long Term Care PharmacyTaxonomy code 3336L0003X

License

PHY50619 Issued in CA

Legal business name

SENIOR CARE PHARMACY SERVICES FAIRFIELD INC

Doing business as

Senior Care Pharmacy Services

Practice address

4950 Fulton Dr
Suite a and B
Fairfield, CA 94534-1615

Phone

(707) 673-9800

Fax

(707) 673-9900

NPI assigned

Jun 27, 2011

Organization subpart

No

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

Authorized official

Name

Samit Banerjee

Title

Ceo

Phone

(714) 891-1800

Specialties & licenses 5

Addresses

Other identifiers 1

Other names 1

• Senior Care Pharmacy Services Doing business as

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• PO-an Lu, PHARM.D, RPH, CGP

  • Pharmacist
  • Garden Grove, CA
  • NPI 1447774328
  NPD (past)

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

{
    "created_epoch": "1309132800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1361318400000",
    "number": "1154617215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 27458",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928090115",
            "telephone_number": "714-891-1800",
            "fax_number": "714-891-1102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4950 FULTON DR",
            "address_2": "SUITE A AND B",
            "city": "FAIRFIELD",
            "state": "CA",
            "postal_code": "945341615",
            "telephone_number": "707-673-9800",
            "fax_number": "707-673-9900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SENIOR CARE PHARMACY SERVICES FAIRFIELD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-27",
        "last_updated": "2013-02-20",
        "status": "A",
        "authorized_official_last_name": "BANERJEE",
        "authorized_official_first_name": "SAMIT",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "714-891-1800"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336I0012X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Institutional Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "CA",
            "license": "PHY50619",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "5641332",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Senior Care Pharmacy Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Long Term Care Pharmacy in Fairfield, CA
• Providers in Fairfield, 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 20, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.