Modernhealth Holdings Inc

Primary specialty

Long Term Care PharmacyTaxonomy code 3336L0003X

License

PHY51002 Issued in CA

Legal business name

MODERNHEALTH HOLDINGS INC

Practice address

13220 Evening Creek Dr S
Ste 110
San Diego, CA 92128-4103

Phone

(858) 668-3350

Fax

(858) 668-3352

NPI assigned

Jun 29, 2009

Organization subpart

No

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

Authorized official

Name

Shannon Chou

Title

Director, Business Operations

Phone

(626) 932-1721

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Modern Health Pharmacy - SD Doing business as

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Bioplus Specialty Infusion Ca, LLC

  • Home Infusion Therapy Pharmacy
  • Torrance, CA
  • NPI 1033135983

  Member Of

  NPD member

Locations

Practitioners 1

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

• Anastasia Lynn George, PHARM D, AAHIVP

  • Pharmacist
  • Los Angeles, CA
  • NPI 1851997225
  NPD (past)

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

{
    "created_epoch": "1246233600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1492560000000",
    "number": "1508094558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 E HUNTINGTON DR",
            "city": "MONROVIA",
            "state": "CA",
            "postal_code": "910163415",
            "telephone_number": "858-668-3350",
            "fax_number": "858-668-3352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13220 EVENING CREEK DR S",
            "address_2": "STE 110",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921284103",
            "telephone_number": "858-668-3350",
            "fax_number": "858-668-3352"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MODERNHEALTH HOLDINGS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-29",
        "last_updated": "2017-04-19",
        "status": "A",
        "authorized_official_last_name": "CHOU",
        "authorized_official_first_name": "SHANNON",
        "authorized_official_title_or_position": "DIRECTOR, BUSINESS OPERATIONS",
        "authorized_official_telephone_number": "626-932-1721"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "CA",
            "license": "PHY51002",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2121362",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1508094558",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Modern Health Pharmacy - SD",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Michael Moctezuma
• Moden Medical Group
• Modern Man TRT LLC
• Modern Meridians
• Modern Therapies LLC
• Lucia Modesti, M.D.
• Modesto Radiological Medical Group, Inc
• Mamta Devshi Modhwadia, M.D
• James G Modir, M.D.
• Royya Fatima Modir, M.D.

• Long Term Care Pharmacy in San Diego, CA
• Providers in San Diego, 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 Apr 19, 2017; 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.