Active NPI
Green Brothers Pharmacy Inc
Doing business as Green Brothers Pharmacy
- Community/Retail Pharmacy
- Stockton, CA
National Provider Identifier
1265548119
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- Legal business name
- GREEN BROTHERS PHARMACY INC
- Doing business as
- Green Brothers Pharmacy
- Practice address
- 1610 N El Dorado St Ste 1
Stockton, CA 95204-5930 - Phone
- (209) 466-2381
- Fax
- (209) 465-1398
- NPI assigned
- Aug 22, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Charles Green, RPH
- Title
- Ceo
- Phone
- (209) 466-2381
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | PHY10612 | CA | |
| Community/Retail Pharmacy | 3336C0003X | Primary |
Addresses
Primary practice location
1610 N El Dorado St Ste 1
Stockton, CA 95204-5930
Mailing address
1610 N El Dorado St Ste 1
Stockton, CA 95204-5930
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0509464 | Other | OTHER ID NUMBER-COMMERCIAL NUMBER | |
| PHD106120 | Medicaid | CA |
Other names 1
- GREEN BROTHERS PHARMACY
National Provider Directory
National Provider DirectoryLocations
1610 N El Dorado St
Ste 1
Stockton, CA 95204
Phone (209) 466-2381
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Pharmacist
- Stockton, CA
- NPI 1720191828
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156204800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1757548800000",
"number": "1265548119",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1610 N EL DORADO ST STE 1",
"city": "STOCKTON",
"state": "CA",
"postal_code": "952045930"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1610 N EL DORADO ST STE 1",
"city": "STOCKTON",
"state": "CA",
"postal_code": "952045930",
"telephone_number": "209-466-2381",
"fax_number": "209-465-1398"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "GREEN BROTHERS PHARMACY INC",
"organizational_subpart": "NO",
"enumeration_date": "2006-08-22",
"last_updated": "2025-09-11",
"status": "A",
"authorized_official_last_name": "GREEN",
"authorized_official_first_name": "CHARLES",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "209-466-2381",
"authorized_official_credential": "RPH"
},
"taxonomies": [
{
"code": "333600000X",
"taxonomy_group": "",
"desc": "Pharmacy",
"state": "CA",
"license": "PHY10612",
"primary": false
},
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
"identifier": "0509464",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "PHD106120",
"state": "CA"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "GREEN BROTHERS PHARMACY",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Stockton, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.