Superior Care Pharmacy Inc

Primary specialty

Long Term Care PharmacyTaxonomy code 3336L0003X

License

PHY 50311 Issued in CA

Legal business name

SUPERIOR CARE PHARMACY INC

Practice address

161 East Main Street
Suite 104
La Mesa, CA 91942-1534

Phone

(619) 785-3993

Fax

(844) 637-2447

NPI assigned

May 24, 2010

Organization subpart

No

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

Authorized official

Name

Mr. Derek M Ishaque

Title

Cfo

Phone

(619) 785-3993

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• SUPERIOR CARE PHARMACY Doing business as

Locations

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

{
    "created_epoch": "1274659200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1454976000000",
    "number": "1295054716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "161 EAST MAIN STREET",
            "address_2": "SUITE 104",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919421534",
            "telephone_number": "619-785-3993",
            "fax_number": "844-637-2447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "161 EAST MAIN STREET",
            "address_2": "SUITE 104",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919421534",
            "telephone_number": "619-785-3993",
            "fax_number": "844-637-2447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUPERIOR CARE PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-05-24",
        "last_updated": "2016-02-09",
        "status": "A",
        "authorized_official_last_name": "ISHAQUE",
        "authorized_official_first_name": "DEREK",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "619-785-3993",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "CA",
            "license": "PHY 50311",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CA",
            "license": "PHY 50311",
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "CA",
            "license": "PHY 50311",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RETAIL PHARMACY PERMIT",
            "identifier": "PHY 50311",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SUPERIOR CARE PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Long Term Care Pharmacy in La Mesa, CA
• Providers in La Mesa, 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 9, 2016; 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.