Progressive Pharmacy, LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PHY55632 Issued in CA

Legal business name

PROGRESSIVE PHARMACY, LLC

Practice address

700 17TH St Ste 101
Modesto, CA 95354-1248

Phone

(209) 857-4778

Fax

(209) 422-6196

NPI assigned

May 11, 2017

Last updated

Feb 28, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Marcus H Howard, PHARM.DNPI 1326576422

Title

Pharmacy Manager

Phone

(209) 857-4778

Specialties & licenses 2

Addresses

Other identifiers 1

Locations

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.

• Marcus Howard, PHARM.D.

  • Pharmacist
  • Modesto, CA
  • NPI 1326576422
  NPD (past) Authorized official

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

{
    "created_epoch": "1494460800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1519776000000",
    "number": "1417483389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 17TH ST",
            "address_2": "SUITE 101",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953541247",
            "telephone_number": "209-857-4778",
            "fax_number": "209-422-6196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 17TH ST STE 101",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953541248",
            "telephone_number": "209-857-4778",
            "fax_number": "209-422-6196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROGRESSIVE PHARMACY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-11",
        "last_updated": "2018-02-28",
        "status": "A",
        "authorized_official_last_name": "HOWARD",
        "authorized_official_first_name": "MARCUS",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "PHARMACY MANAGER",
        "authorized_official_telephone_number": "209-857-4778",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHARM.D"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CA",
            "license": "PHY55632",
            "primary": true
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CALIFORNIA STATE BOARD OF PHARMACY LICENSE",
            "identifier": "PHY55632",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Community/Retail Pharmacy in Modesto, CA
• Providers in Modesto, 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 28, 2018; 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.