Mendota Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

MENDOTA PHARMACY INC

Doing business as

Mendota Pharmacy

Practice address

497 Oller St
Mendota, CA 93640-2312

Phone

(559) 382-2080

NPI assigned

Dec 15, 2020

Last updated

Dec 15, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Fadhl Ali, RPHNPI 1164940185

Title

Owner

Phone

(559) 382-2080

Specialties & licenses 1

Addresses

Other names 1

• Mendota Pharmacy Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

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.

• Fadhl Ali

  • Pharmacist
  • Mendota, CA
  • NPI 1164940185
  NPD Authorized official

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

{
    "created_epoch": "1607990400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1607990400000",
    "number": "1609462597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "497 OLLER ST",
            "city": "MENDOTA",
            "state": "CA",
            "postal_code": "936402312",
            "telephone_number": "559-382-2080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "497 OLLER ST",
            "city": "MENDOTA",
            "state": "CA",
            "postal_code": "936402312",
            "telephone_number": "559-382-2080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MENDOTA PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-15",
        "last_updated": "2020-12-15",
        "certification_date": "2020-12-15",
        "status": "A",
        "authorized_official_last_name": "ALI",
        "authorized_official_first_name": "FADHL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "559-382-2080",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mendota Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jasdave S. Maan, MD
• Madera Community Hospital (Family Health Services - Mendota)
• Raman Mattu, M.D.
• Robert McLeod, P.A.
• Yvette Lopez Mendez, LCSW
• Mendota Unified School District
• Trang M Nguyen, D.D.S.
• Pharmkee, Inc. (Mendota Drug)
• Promesa Behavioral Health
• Promesa Behavioral Health

• Community/Retail Pharmacy in Mendota, CA
• Providers in Mendota, 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 Dec 15, 2020; 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.