St Mary Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

56096 Issued in CA

Legal business name

ST MARY PHARMACY INC

Doing business as

St Mary Pharmacy

Practice address

8254 White Oak Ave Unit 4
Northridge, CA 91325-4367

Phone

(818) 975-8004

Fax

(818) 975-8094

NPI assigned

Apr 24, 2018

Organization subpart

No

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

Authorized official

Name

Dr. Beshoy I Gerges, PHARM DNPI 1487019469

Title

President/Pic

Phone

(818) 975-8004

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• ST MARY PHARMACY Doing business as

Medicare fee-for-service enrollment

Enrolled in CA3 enrollments

Enrollment records 3

Tax ID family

St Mary Pharmacy Inc2 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.

• St Mary Pharmacy Inc

  • Long Term Care Pharmacy
  • Northridge, CA
  • NPI 1013760891
  NPD tax ID

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

• Ipbs Inc

  dba St Mary Pharmacy

  • Community/Retail Pharmacy
  • Chatsworth, CA
  • NPI 1467094995

  Member Of

  NPD member

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.

• Beshoy Gerges, PHARMD

  • Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
  • Northridge, CA
  • NPI 1487019469
  NPD (past) Authorized official

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

{
    "created_epoch": "1524528000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1643846400000",
    "number": "1356839559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8254 WHITE OAK AVE UNIT 4",
            "city": "NORTHRIDGE",
            "state": "CA",
            "postal_code": "913254367",
            "telephone_number": "818-975-8004",
            "fax_number": "818-975-8094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8254 WHITE OAK AVE UNIT 4",
            "city": "NORTHRIDGE",
            "state": "CA",
            "postal_code": "913254367",
            "telephone_number": "818-975-8004",
            "fax_number": "818-975-8094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST MARY PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-24",
        "last_updated": "2022-02-03",
        "certification_date": "2022-02-03",
        "status": "A",
        "authorized_official_last_name": "GERGES",
        "authorized_official_first_name": "BESHOY",
        "authorized_official_middle_name": "I",
        "authorized_official_title_or_position": "PRESIDENT/PIC",
        "authorized_official_telephone_number": "818-975-8004",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHARM D"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CA",
            "license": "56096",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOARD OF PHARMACY PERMIT",
            "identifier": "PHY56096",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ST MARY PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Retail Pharmacy in Northridge, CA
• Providers in Northridge, CA by specialty
• Community/Retail Pharmacy in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2022; 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.