Organization Active NPI

Servrite Drug

  • Community/Retail Pharmacy
  • Pico Rivera, CA
National Provider Identifier
1518023720
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PHY34009 Issued in CA
Legal business name
SERVRITE DRUG
Practice address
9420 Slauson Ave
Pico Rivera, CA 90660-4748
Phone
(562) 948-1905
Fax
(562) 948-3017
NPI assigned
Dec 29, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Robert M Lane
Title
President
Phone
(562) 948-1905

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X PHY34009 CA Primary

Addresses

Primary practice location

9420 Slauson Ave
Pico Rivera, CA 90660-4748

Mailing address

9420 Slauson Ave
Pico Rivera, CA 90660-4748
Phone (562) 948-1905

Other identifiers 2

IdentifierTypeStateIssuer
PHY34009MedicaidCA
PHA340090OtherCAMEDICAL

National Provider Directory

National Provider Directory

Locations

9420 Slauson Ave
Pico Rivera, CA 90660
Phone (562) 222-2020

NPI Registry JSON

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

{
    "created_epoch": "1167350400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1518023720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9420 SLAUSON AVE",
            "city": "PICO RIVERA",
            "state": "CA",
            "postal_code": "906604748",
            "telephone_number": "562-948-1905",
            "fax_number": "562-948-3017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9420 SLAUSON AVE",
            "city": "PICO RIVERA",
            "state": "CA",
            "postal_code": "906604748",
            "telephone_number": "562-948-1905",
            "fax_number": "562-948-3017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SERVRITE DRUG",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-29",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LANE",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "562-948-1905"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CA",
            "license": "PHY34009",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PHY34009",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL",
            "identifier": "PHA340090",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pico Rivera, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.