Mission Wellness Healthcare LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

54390 Issued in CA

Legal business name

MISSION WELLNESS HEALTHCARE LLC

Doing business as

Mission Wellness Pharmacy

Practice address

2424 Mission St
San Francisco, CA 94110-2415

Phone

(415) 826-3484

Fax

(415) 826-7077

NPI assigned

Oct 1, 2013

Organization subpart

No

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

Authorized official

Name

Maria Andrzejek

Title

Director

Phone

(415) 826-3484

Specialties & licenses 4

Addresses

Other identifiers 2

Other names 1

• Mission Wellness Pharmacy Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Mission Wellness Healthcare LLC

  • Pharmacy
  • San Francisco, CA
  • NPI 1215473939

  O20160609001752

  Same enrollment

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Brian W Balbon, D.C

  • Chiropractor
  • San Francisco, CA
  • NPI 1487728242
  NPD (past)

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

{
    "created_epoch": "1380585600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1461110400000",
    "number": "1518394857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7775 #52191",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "94120",
            "telephone_number": "415-826-3484",
            "fax_number": "415-738-7947"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2424 MISSION ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941102415",
            "telephone_number": "415-826-3484",
            "fax_number": "415-826-7077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MISSION WELLNESS HEALTHCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-01",
        "last_updated": "2016-04-20",
        "status": "A",
        "authorized_official_last_name": "ANDRZEJEK",
        "authorized_official_first_name": "MARIA",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "415-826-3484"
    },
    "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": "54390",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2142357",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PHA471220",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mission Wellness Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Mission Neighborhood Resource Center
• Mission Neighborhood Resource Center
• Mission Optometry Inc
• Mission Podiatry Group Inc
• Mission Wellness Healthcare LLC
• Mission Wellness Healthcare LLC
• Mission Wellness Pharmacy
• Donald M Missirlian
• Samantha Ann Misslbeck, NP
• Rhea Mistades, LMFT

• Community/Retail Pharmacy in San Francisco, CA
• Providers in San Francisco, 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 Apr 20, 2016; 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.