St Cyril Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PHY56036 Issued in CA

Legal business name

ST CYRIL INC

Practice address

1525 Mesa Verde Dr E Ste 101
Costa Mesa, CA 92626-5221

Phone

(714) 884-3574

Fax

(714) 486-1027

NPI assigned

Jun 25, 2015

Organization subpart

No

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

Authorized official

Name

Genevieve Benjamin, PHARM D

Title

Ceo/ President

Phone

(949) 293-9857

Specialties & licenses 4

Addresses

Other identifiers 1

Other names 1

• Mesa Verde Pharmacy Doing business as

Medicare fee-for-service enrollment

Enrolled in CA2 enrollments

Enrollment records 2

Locations

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

{
    "created_epoch": "1435190400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707350400000",
    "number": "1467834580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1525 MESA VERDE DR E STE 101",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926265221",
            "telephone_number": "714-884-3574",
            "fax_number": "714-486-1027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1525 MESA VERDE DR E STE 101",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926265221",
            "telephone_number": "714-884-3574",
            "fax_number": "714-486-1027"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST CYRIL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-25",
        "last_updated": "2024-02-08",
        "certification_date": "2023-09-20",
        "status": "A",
        "authorized_official_last_name": "BENJAMIN",
        "authorized_official_first_name": "GENEVIEVE",
        "authorized_official_title_or_position": "CEO/ PRESIDENT",
        "authorized_official_telephone_number": "949-293-9857",
        "authorized_official_credential": "PHARM D"
    },
    "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": "PHY56036",
            "primary": true
        },
        {
            "code": "3336H0001X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Home Infusion Therapy Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2152982",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mesa Verde Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Mesa Verde Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Michael Jeffrey Spitzer, D.D.S.
• Jaime Spray, PH.D.
• Cory S Spurlock, MD
• Ssmena Pharm Inc
• St Cyril Inc
• St. Clair Senior Care LLC
• St. Joseph Health System Home Care Services
• St. Joseph Health System Home Care Services
• Stacey Gillis Chiropractic Inc
• Danielle Stadelman, RDN

• Community/Retail Pharmacy in Costa Mesa, CA
• Providers in Costa Mesa, 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 8, 2024; 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.