Eureka Pharmacy LLC

Primary specialty

Long Term Care PharmacyTaxonomy code 3336L0003X

Legal business name

EUREKA PHARMACY LLC

Doing business as

Cloneys Long Term Care Pharmacy

Practice address

525 5TH St Ste B
Eureka, CA 95501-1032

Phone

(707) 443-8452

Fax

(707) 443-2443

NPI assigned

Apr 20, 2011

Last updated

Aug 10, 2021By 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

Mr. Pratap Krishna AnneNPI 1699911412

Title

Managing Member

Phone

(209) 298-1715

Specialties & licenses 3

Addresses

Other identifiers 2

Other names 1

• CLONEYS LONG TERM CARE PHARMACY Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Eureka Pharmacy LLC

  dba Red Cross Pharmacy

  • Community/Retail Pharmacy
  • Eureka, CA
  • NPI 1841978509

  O20210924002290

  Same enrollment

Tax ID family

Eureka Pharmacy LLC2 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.

• Eureka Pharmacy LLC

  dba Red Cross Pharmacy

  • Community/Retail Pharmacy
  • Eureka, CA
  • NPI 1841978509
  NPD tax ID

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Pratap Krishna Anne, RPH

  • Pharmacist
  • Stockton, CA
  • NPI 1699911412
  Authorized official Same address or phone

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

{
    "created_epoch": "1303257600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1628553600000",
    "number": "1164713517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 5TH ST",
            "city": "EUREKA",
            "state": "CA",
            "postal_code": "955011032",
            "telephone_number": "707-443-8452",
            "fax_number": "707-443-3059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 5TH ST STE B",
            "city": "EUREKA",
            "state": "CA",
            "postal_code": "955011032",
            "telephone_number": "707-443-8452",
            "fax_number": "707-443-2443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EUREKA PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-20",
        "last_updated": "2021-08-10",
        "certification_date": "2021-08-10",
        "status": "A",
        "authorized_official_last_name": "ANNE",
        "authorized_official_first_name": "PRATAP",
        "authorized_official_middle_name": "KRISHNA",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "209-298-1715",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1164713517",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2129858",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CLONEYS LONG TERM CARE PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Eureka Family Practice
• Eureka Healthcare and Rehabilitation Center, LLC
• Eureka Internal Medicine
• Eureka OBGYN
• Eureka Pediatrics Medical Practice
• Eureka Pharmacy LLC (Red Cross Pharmacy)
• Eureka Physical Therapy
• Eureka Radiation Oncology
• Eureka Radiation Oncology Consultants
• Eureka Rehabilitation & Wellness Center, LP

• Long Term Care Pharmacy in Eureka, CA
• Providers in Eureka, 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 Aug 10, 2021; 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.