Mission Wellness Healthcare LLC

Primary specialty

PharmacyTaxonomy code 333600000X

License

55442 Issued in CA

Legal business name

MISSION WELLNESS HEALTHCARE LLC

Practice address

350 Parnassus Ave Ste 505
San Francisco, CA 94117-3628

Phone

(415) 926-6270

Fax

(415) 826-7077

NPI assigned

Jan 19, 2017

Organization subpart

No

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

Authorized official

Name

Daniel Andrzejek

Title

Ceo

Phone

(415) 577-4743

Specialties & licenses 2

Addresses

Other identifiers 1

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.

• Mission Wellness Healthcare LLC

  dba Mission Wellness Pharmacy

  • Community/Retail Pharmacy
  • San Francisco, CA
  • NPI 1518394857

  O20160609001752

  Same enrollment

Locations

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

{
    "created_epoch": "1484784000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1526256000000",
    "number": "1215473939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO 7775 #52191",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "94120",
            "telephone_number": "415-577-4743"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 PARNASSUS AVE STE 505",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941173628",
            "telephone_number": "415-926-6270",
            "fax_number": "415-826-7077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MISSION WELLNESS HEALTHCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-19",
        "last_updated": "2018-05-14",
        "status": "A",
        "authorized_official_last_name": "ANDRZEJEK",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "415-577-4743"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "CA",
            "license": "55442",
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2167370",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mission Neighborhood Health Center-Valencia Clinic
• Mission Neighborhood Resource Center
• Mission Neighborhood Resource Center
• Mission Optometry Inc
• Mission Podiatry Group Inc
• Mission Wellness Healthcare LLC (Mission Wellness Pharmacy)
• Mission Wellness Healthcare LLC
• Mission Wellness Pharmacy
• Donald M Missirlian
• Samantha Ann Misslbeck, NP

• Pharmacy in San Francisco, CA
• Providers in San Francisco, CA by specialty
• Pharmacy in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2018; 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.