Entag Inc

Primary specialty

Long Term Care PharmacyTaxonomy code 3336L0003X

License

PHY50669 Issued in CA

Legal business name

ENTAG INC

Doing business as

Medicine Care Pharmacy

Practice address

1685 E Main St Ste 103
El Cajon, CA 92021-5225

Phone

(619) 401-7077

Fax

(619) 951-3136

NPI assigned

Jun 20, 2011

Last updated

May 20, 2016By 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

Behrooz Behzadi

Title

Vice President

Phone

(408) 892-0136

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• Medicine Care Pharmacy Doing business as

Locations

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

{
    "created_epoch": "1308528000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1463702400000",
    "number": "1487949319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1685 E MAIN ST",
            "address_2": "#103",
            "city": "EL CAJON",
            "state": "CA",
            "postal_code": "920215225",
            "telephone_number": "619-401-7077",
            "fax_number": "619-951-3136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1685 E MAIN ST STE 103",
            "city": "EL CAJON",
            "state": "CA",
            "postal_code": "920215225",
            "telephone_number": "619-401-7077",
            "fax_number": "619-951-3136"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENTAG INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-20",
        "last_updated": "2016-05-20",
        "status": "A",
        "authorized_official_last_name": "BEHZADI",
        "authorized_official_first_name": "BEHROOZ",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "408-892-0136"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "CA",
            "license": "PHY50669",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2130689",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Medicine Care Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Long Term Care Pharmacy in El Cajon, CA
• Providers in El Cajon, CA by specialty
• Long Term Care Pharmacy in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2016; 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.