NPIMap

Organization Active NPI

Hallers LTC Pharmacy, Inc.

  • Long Term Care Pharmacy
  • Fremont, CA
National Provider Identifier
1366598161
Registry record updated Aug 7, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
Legal business name
HALLERS LTC PHARMACY, INC.
Practice address
4067 Peralta Blvd
Fremont, CA 94536-4849
Phone
(510) 793-5096
Fax
(510) 745-9950
NPI assigned
Jan 25, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2019

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

Authorized official

Name
Aarondeep BasraiNPI 1598065328
Title
Ceo
Phone
(510) 793-5096

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)CodeLicenseStatePrimary
Compounding Pharmacy 3336C0004X
Long Term Care Pharmacy 3336L0003X Primary

Addresses

Primary practice location

4067 Peralta Blvd
Fremont, CA 94536-4849

Mailing address

4067 Peralta Blvd
Fremont, CA 94536-4849
Phone (510) 793-5096

Other names 1

  • Haller's LTC Pharmacy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210208002119 CA Part B Supplier - Mass Immunization (Roster Biller Only) 7113352584 Practice locations: Fremont, CA

National Provider Directory

National Provider Directory
Tax ID family
Washington Medical Phcy3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

4067 Peralta Blvd
Fremont, CA 94536
Phone (510) 793-5096

Practitioners & affiliated clinicians

Practitioners 3

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": "1169683200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1565136000000",
    "number": "1366598161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4067 PERALTA BLVD",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945364849",
            "telephone_number": "510-793-5096",
            "fax_number": "510-745-9950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4067 PERALTA BLVD",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945364849",
            "telephone_number": "510-793-5096",
            "fax_number": "510-745-9950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HALLERS LTC PHARMACY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-25",
        "last_updated": "2019-08-07",
        "status": "A",
        "authorized_official_last_name": "BASRAI",
        "authorized_official_first_name": "AARONDEEP",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "510-793-5096"
    },
    "taxonomies": [
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Haller's LTC Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Haller's LTC Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fremont, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2019; 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.