CGM Pharmacy Corporation

Primary specialty

Long Term Care PharmacyTaxonomy code 3336L0003X

License

PHY55112 Issued in CA

Legal business name

CGM PHARMACY CORPORATION

Practice address

1340 Blue Oaks Blvd Ste 110
Roseville, CA 95678-7038

Phone

(916) 771-4778

Fax

(916) 771-0492

NPI assigned

Jun 26, 2017

Organization subpart

No

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

Authorized official

Name

Glory Anne Velilla

Title

Secretary

Phone

(916) 771-4778

Specialties & licenses 1

Addresses

Other names 1

• BLUE OAKS LTC PHARMACY Doing business as

Locations

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

{
    "created_epoch": "1498435200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1306366950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1340 BLUE OAKS BLVD STE 110",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956787038",
            "telephone_number": "916-771-4778",
            "fax_number": "916-771-0492"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1340 BLUE OAKS BLVD STE 110",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956787038",
            "telephone_number": "916-771-4778",
            "fax_number": "916-771-0492"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CGM PHARMACY CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-26",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "VELILLA",
        "authorized_official_first_name": "GLORY ANNE",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "916-771-4778"
    },
    "taxonomies": [
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "CA",
            "license": "PHY55112",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BLUE OAKS LTC PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Cep America - California
• Anjali J Cera, MD
• David G Cernik, DDS
• Wendy M. Cerny, MD
• Jose Cervantes, MA
• CH Specialty Services Ca PC
• Sarai Chagolla
• Javier Chairez Jr., MR.
• Letty Crystal Chairez
• Emily Joy Chalfant, PA-C

• Long Term Care Pharmacy in Roseville, CA
• Providers in Roseville, 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 Jul 21, 2022; 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.