Organization Active NPI

Ascencion Inc

  • Community/Retail Pharmacy
  • Los Osos, CA
National Provider Identifier
1366554289
Registry record updated Jun 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PHY22201 Issued in CA
Legal business name
ASCENCION INC
Practice address
989 Los Osos Valley Rd
Los Osos, CA 93402-3205
Phone
(805) 528-1017
Fax
(805) 528-1915
NPI assigned
Aug 31, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2016

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

Authorized official

Name
Gary Tewell
Title
President
Phone
(805) 528-1017

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X PHY22201 CA Primary

Addresses

Primary practice location

989 Los Osos Valley Rd
Los Osos, CA 93402-3205

Mailing address

989 Los Osos Valley Rd
Los Osos, CA 93402-3205
Phone (805) 528-1017

Other identifiers 2

IdentifierTypeStateIssuer
PHA206500MedicaidCA
2115987OtherPK

Other names 1

  • LOS OSOS REXALL DRUG STORE Doing business as

National Provider Directory

National Provider Directory

Locations

989 Los Osos Valley Rd
Los Osos, CA 93402
Phone (805) 528-1017

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1467072000000",
    "number": "1366554289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "989 LOS OSOS VALLEY RD",
            "city": "LOS OSOS",
            "state": "CA",
            "postal_code": "934023205",
            "telephone_number": "805-528-1017",
            "fax_number": "805-528-1915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "989 LOS OSOS VALLEY RD",
            "city": "LOS OSOS",
            "state": "CA",
            "postal_code": "934023205",
            "telephone_number": "805-528-1017",
            "fax_number": "805-528-1915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ASCENCION INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2016-06-28",
        "status": "A",
        "authorized_official_last_name": "TEWELL",
        "authorized_official_first_name": "GARY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "805-528-1017"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CA",
            "license": "PHY22201",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PHA206500",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2115987",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LOS OSOS REXALL DRUG STORE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Los Osos, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 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.