Active NPI
Lifemed, Inc.
- Long Term Care Pharmacy
- Redding, CA
National Provider Identifier
1609230994
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Long Term Care Pharmacy
- Legal business name
- LIFEMED, INC.
- Practice address
- 2025 Court St Ste E
Redding, CA 96001-1805 - Phone
- (530) 241-3550
- Fax
- (530) 241-3605
- NPI assigned
- Apr 12, 2016
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. John Friesen
- Title
- Ceo
- Phone
- (530) 246-1075
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Long Term Care Pharmacy | 3336L0003X | Primary |
Addresses
Primary practice location
2025 Court St Ste E
Redding, CA 96001-1805
Mailing address
PO Box 993668
Redding, CA 96099-3668
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PHY54477 | Other | CA | CA BOP |
| 1609230994 | Medicaid | CA | |
| 5659733 | Other | NCPDP |
Other names 1
- Lifemed
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20171017001769 | CA | Part B Supplier - Mass Immunization (Roster Biller Only) | 0244506327 | Practice locations: Redding, CA |
| O20171211002308 | CA | DME Supplier - Pharmacy | 0244506327 | Practice locations: Redding, CA |
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
Medicare medical equipment & supply locations
| Supplier | Supplies | Medicare assignment |
|---|---|---|
| Lifemed | Epoetin|Immunosuppressive Drugs|Infusion Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs | Accepts assignment |
National Provider Directory
National Provider DirectoryLocations
2025 Court St
Ste E
Redding, CA 96001
Phone (530) 241-3550
2247 Court St
Redding, CA 96001
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1460419200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1674172800000",
"number": "1609230994",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 993668",
"city": "REDDING",
"state": "CA",
"postal_code": "960993668"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2025 COURT ST STE E",
"city": "REDDING",
"state": "CA",
"postal_code": "960011805",
"telephone_number": "530-241-3550",
"fax_number": "530-241-3605"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "LIFEMED, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2016-04-12",
"last_updated": "2023-01-20",
"certification_date": "2023-01-20",
"status": "A",
"authorized_official_last_name": "FRIESEN",
"authorized_official_first_name": "JOHN",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "530-246-1075",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "3336L0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Long Term Care Pharmacy",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CA BOP",
"identifier": "PHY54477",
"state": "CA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1609230994",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NCPDP",
"identifier": "5659733",
"state": null
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Lifemed",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Redding, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.