Three Rivers Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

51549 Issued in CA

Legal business name

THREE RIVERS PHARMACY INC

Practice address

40893 Sierra Dr
Three Rivers, CA 93271-9583

Phone

(559) 561-4217

Fax

(559) 561-4168

NPI assigned

Sep 13, 2006

Organization subpart

No

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

Authorized official

Name

David Stanley, BSPHARMNPI 1104112754

Title

RPH.

Phone

(559) 561-4217

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Three Rivers Drug Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 1

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

• David Stanley

  • Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
  • Three Rivers, CA
  • NPI 1104112754
  NPD Authorized official

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

{
    "created_epoch": "1158105600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1487203200000",
    "number": "1477658797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 415",
            "city": "THREE RIVERS",
            "state": "CA",
            "postal_code": "932710415",
            "telephone_number": "559-561-4217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40893 SIERRA DR",
            "city": "THREE RIVERS",
            "state": "CA",
            "postal_code": "932719583",
            "telephone_number": "559-561-4217",
            "fax_number": "559-561-4168"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THREE RIVERS PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-13",
        "last_updated": "2017-02-16",
        "status": "A",
        "authorized_official_last_name": "STANLEY",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "RPH.",
        "authorized_official_telephone_number": "559-561-4217",
        "authorized_official_credential": "BSPHARM"
    },
    "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": "51549",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2141848",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PHA19470",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Three Rivers Drug",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Melissa Anne Mertz, FNP-C
• Donald Wayne Mosley, DDS
• Saiba Hospitalist Associates
• Sierra Family Practice Partners PC
• David Stanley
• US Department of the Interior, National Park Service
• Avira Wenn, CD(DONA)

• Community/Retail Pharmacy in Three Rivers, CA
• Providers in Three Rivers, 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 16, 2017; 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.