Minims Apothecary LLC, Dba Baneth'S Pharmacy

Primary specialty

Compounding PharmacyTaxonomy code 3336C0004X

License

PHY48368 Issued in CA

Legal business name

MINIMS APOTHECARY LLC, DBA BANETH'S PHARMACY

Practice address

900 Willow Rd
Menlo Park, CA 94025-2544

Phone

(650) 326-8400

Fax

(650) 323-2609

NPI assigned

Sep 12, 2006

Organization subpart

No

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

Authorized official

Name

Ms. Sageda Mahmoud-ThirucoteNPI 1063785632

Title

Pharmacist - in - Charge

Phone

(650) 326-8400

Specialties & licenses 3

Addresses

Other identifiers 2

Locations

Practitioners 1

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

• Sageda Mahmoud-Thirucote, RPH

  • Pharmacist
  • Menlo Park, CA
  • NPI 1063785632
  NPD (past) Authorized official

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

{
    "created_epoch": "1158019200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1237852800000",
    "number": "1497859441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 WILLOW RD",
            "city": "MENLO PARK",
            "state": "CA",
            "postal_code": "940252544",
            "telephone_number": "650-326-8400",
            "fax_number": "650-323-2609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 WILLOW RD",
            "city": "MENLO PARK",
            "state": "CA",
            "postal_code": "940252544",
            "telephone_number": "650-326-8400",
            "fax_number": "650-323-2609"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINIMS APOTHECARY LLC, DBA BANETH'S PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-12",
        "last_updated": "2009-03-24",
        "status": "A",
        "authorized_official_last_name": "MAHMOUD-THIRUCOTE",
        "authorized_official_first_name": "SAGEDA",
        "authorized_official_title_or_position": "PHARMACIST - IN - CHARGE",
        "authorized_official_telephone_number": "650-326-8400",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "CA",
            "license": "PHY46536",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": "CA",
            "license": "PHY48368",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "0523123",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PHA465360",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tara D Miller, MD
• Zachary Michael Miller, M.D.
• Mills-Peninsula Health Services
• Virginia Victoria Mills, RN,PHN,NP
• David L. Mineau
• Carolyn F Mischer, MD
• Allan Kumar Mishra, MD
• Laura Missan
• Kamesha Roshun Mitchell, NP
• Meri Mitsuyoshi, LMFT

• Compounding Pharmacy in Menlo Park, CA
• Providers in Menlo Park, CA by specialty
• Compounding Pharmacy in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2009; 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.