NPIMap

Organization Active NPI

North East Medical Services

  • Pharmacy
  • San Francisco, CA
National Provider Identifier
1578211504
Registry record updated Mar 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
Legal business name
NORTH EAST MEDICAL SERVICES
Practice address
728 Pacific Ave Ste 115
San Francisco, CA 94133-4449
Phone
(415) 391-9686
NPI assigned
Mar 18, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2022

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

Authorized official

Name
Eddie W Chan, PHARMD
Title
President & Ceo
Phone
(415) 391-9686

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X
Pharmacy 333600000X Primary

Addresses

Primary practice location

728 Pacific Ave Ste 115
San Francisco, CA 94133-4449

Mailing address

2171 Junipero Serra Blvd Ste 200
Daly City, CA 94014-1986
Phone (415) 352-5031

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20201026001202 CA Part B Supplier - Mass Immunization (Roster Biller Only) 4284520529 7 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Daly City, CA; San Francisco, CA; San Jose, CA

Other NPIs on the same Medicare enrollment 7

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

National Provider Directory

National Provider Directory
Tax ID family
North East Medical Services57 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

2171 Junipero Serra Blvd
Ste 200
Daly City, CA 94014

728 Pacific Ave
Ste 115
San Francisco, CA 94133

NPI Registry JSON

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

{
    "created_epoch": "1647561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1647561600000",
    "number": "1578211504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2171 JUNIPERO SERRA BLVD STE 200",
            "city": "DALY CITY",
            "state": "CA",
            "postal_code": "940141986",
            "telephone_number": "415-352-5031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "728 PACIFIC AVE STE 115",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941334449",
            "telephone_number": "415-391-9686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH EAST MEDICAL SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-18",
        "last_updated": "2022-03-18",
        "certification_date": "2022-03-04",
        "status": "A",
        "authorized_official_last_name": "CHAN",
        "authorized_official_first_name": "EDDIE",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "PRESIDENT & CEO",
        "authorized_official_telephone_number": "415-391-9686",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2022; 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.