Neeley Family, Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PHY412710 Issued in CA

Legal business name

NEELEY FAMILY, INC

Practice address

347 Lakeport Blvd
Lakeport, CA 95453-5412

Phone

(707) 263-1328

Fax

(707) 263-0864

NPI assigned

Jul 10, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Robert Daniel Neeley

Title

Owner

Phone

(707) 263-1328

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• North Lake Medical Pharmacy #2 Doing business as

Medicare fee-for-service enrollment

Enrolled in CA2 enrollments

Enrollment records 2

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Medicare medical equipment & supply locations

Locations

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

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721779200000",
    "number": "1376577023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "347 LAKEPORT BLVD",
            "city": "LAKEPORT",
            "state": "CA",
            "postal_code": "954535412",
            "telephone_number": "707-263-1328",
            "fax_number": "707-263-0864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "347 LAKEPORT BLVD",
            "city": "LAKEPORT",
            "state": "CA",
            "postal_code": "954535412",
            "telephone_number": "707-263-1328",
            "fax_number": "707-263-0864"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEELEY FAMILY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-10",
        "last_updated": "2024-07-24",
        "certification_date": "2024-07-24",
        "status": "A",
        "authorized_official_last_name": "NEELEY",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "DANIEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "707-263-1328",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CA",
            "license": "PHY412710",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PHA412710",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "North Lake Medical Pharmacy #2",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Annette Joyce Moynier
• Darcene Melaac Munir, M.D.
• Heather Murray, RN, IBCLC
• Michael Lee Murrray, R.PH
• Neeley Clinical Services Inc
• Neeley, Inc
• Neeley, Inc
• Kyla Neeley, PHARMD
• James F Neighbors, RPH
• Maryanne Nersesyan, DDS

• Community/Retail Pharmacy in Lakeport, CA
• Providers in Lakeport, 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 Jul 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.