NPIMap

Organization Active NPI

Redwood Pharmacies

  • Pharmacy
  • Eureka, CA
National Provider Identifier
1629075916
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
License
PHY45220 Issued in CA
Legal business name
REDWOOD PHARMACIES
Practice address
1694 Myrtle Ave
Eureka, CA 95501-1403
Phone
(707) 443-4885
Fax
(707) 443-6527
NPI assigned
Jul 1, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Erin King
Title
General Manager
Phone
(707) 443-4885

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X PHY45220 CA Primary

Addresses

Primary practice location

1694 Myrtle Ave
Eureka, CA 95501-1403

Mailing address

1694 Myrtle Ave
Eureka, CA 95501-1403
Phone (707) 443-4885

Other identifiers 2

IdentifierTypeStateIssuer
PHA452200MedicaidCA
PHY45220OtherCASTATE BOARD LICENSE

National Provider Directory

National Provider Directory
Tax ID family
Myrtletowne3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1694 Myrtle Ave
Eureka, CA 95501
Phone (707) 443-4885

NPI Registry JSON

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

{
    "created_epoch": "1120176000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1629075916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1694 MYRTLE AVE",
            "city": "EUREKA",
            "state": "CA",
            "postal_code": "955011403",
            "telephone_number": "707-443-4885",
            "fax_number": "707-443-6527"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1694 MYRTLE AVE",
            "city": "EUREKA",
            "state": "CA",
            "postal_code": "955011403",
            "telephone_number": "707-443-4885",
            "fax_number": "707-443-6527"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REDWOOD PHARMACIES",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-01",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KING",
        "authorized_official_first_name": "ERIN",
        "authorized_official_title_or_position": "GENERAL MANAGER",
        "authorized_official_telephone_number": "707-443-4885"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "CA",
            "license": "PHY45220",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PHA452200",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE BOARD LICENSE",
            "identifier": "PHY45220",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Eureka, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.