NPIMap

Organization Active NPI

Costco 1042

  • Pharmacy
  • Redwood City, CA
National Provider Identifier
1154799922
Registry record updated Sep 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
License
56490 Issued in CA
Legal business name
COSTCO 1042
Practice address
2300 Middlefield Rd
Redwood City, CA 94063-2854
Phone
(650) 568-4049
NPI assigned
Sep 9, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2015

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

Authorized official

Name
Mrs. Lakshmi Gangiredla, RPH
Title
Pharmacy/Manager
Phone
(650) 568-4049

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X 56490 CA Primary

Addresses

Primary practice location

2300 Middlefield Rd
Redwood City, CA 94063-2854

Mailing address

2300 Middlefield Rd
Redwood City, CA 94063-2854
Phone (650) 568-4049

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1441756800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1441756800000",
    "number": "1154799922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 MIDDLEFIELD RD",
            "city": "REDWOOD CITY",
            "state": "CA",
            "postal_code": "940632854",
            "telephone_number": "650-568-4049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 MIDDLEFIELD RD",
            "city": "REDWOOD CITY",
            "state": "CA",
            "postal_code": "940632854",
            "telephone_number": "650-568-4049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COSTCO 1042",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-09",
        "last_updated": "2015-09-09",
        "status": "A",
        "authorized_official_last_name": "GANGIREDLA",
        "authorized_official_first_name": "LAKSHMI",
        "authorized_official_title_or_position": "PHARMACY/MANAGER",
        "authorized_official_telephone_number": "650-568-4049",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "CA",
            "license": "56490",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redwood City, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2015; 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.