White Cross Drug Store

Primary specialty

Long Term Care PharmacyTaxonomy code 3336L0003X

License

PHY45196 Issued in CA

Legal business name

WHITE CROSS DRUG STORE

Practice address

4074 Fairmount Ave
San Diego, CA 92105-1608

Phone

(619) 284-1141

Fax

(619) 284-0503

NPI assigned

Aug 10, 2006

Organization subpart

No

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

Authorized official

Name

Max Atiya

Title

Owner

Phone

(619) 284-1141

Specialties & licenses 2

Addresses

Other identifiers 3

Locations

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

{
    "created_epoch": "1155168000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1188518400000",
    "number": "1609887199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4074 FAIRMOUNT AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921051608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4074 FAIRMOUNT AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921051608",
            "telephone_number": "619-284-1141",
            "fax_number": "619-284-0503"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WHITE CROSS DRUG STORE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-10",
        "last_updated": "2007-08-31",
        "status": "A",
        "authorized_official_last_name": "ATIYA",
        "authorized_official_first_name": "MAX",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "619-284-1141"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "CA",
            "license": "PHY45196",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER",
            "identifier": "0595681",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PHA451960",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "0595681",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rachel Whitaker
• Judith Ann Whitcher, LPCC
• Emily L Whitcomb, M.D.
• Kate M Whitcomb
• Tera Lee Whitcomb
• Nicole White-Madolora
• Carol Ann White-Melton
• Aimee J White, RN
• Alexis White
• Allison D White, AGACNP-BC

• Long Term Care Pharmacy in San Diego, CA
• Providers in San Diego, CA by specialty
• Long Term Care Pharmacy in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2007; 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.