Marin Wellness Pharmacy LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

MARIN WELLNESS PHARMACY LLC

Practice address

170 Professional Center Dr Ste C
Rohnert Park, CA 94928-2169

Phone

(707) 953-4528

NPI assigned

Mar 27, 2025

Organization subpart

Yes

Parent organization

MARIN WELLNESS PHARMACY LLCAs reported in NPPES

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

Authorized official

Name

Moussie Hailemariam

Title

Ceo

Phone

(707) 953-4528

Specialties & licenses 3

Addresses

Other names 1

• Apex Infusion Pharmacy Rohnert Park Doing business as

Medicare fee-for-service enrollment

Enrolled in CA2 enrollments

Enrollment records 2

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Marin Wellness Pharmacy LLC

  • Home Infusion Therapy Pharmacy
  • Signal Hill, CA
  • NPI 1457602294

  5193141463

  Same PAC ID

Other NPIs on the same Medicare enrollment 1

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

• Marin Wellness Pharmacy LLC

  • Home Infusion Therapy Pharmacy
  • Signal Hill, CA
  • NPI 1457602294

  O20241219002789

  Same enrollment

These 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

Tax ID family

Marin Wellness Pharmacy LLC2 organizations share this tax ID, including this one

Part of

Marin Wellness Pharmacy LLC

Other organizations with this tax ID 1

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

• Marin Wellness Pharmacy, Inc.

  • Community/Retail Pharmacy
  • San Rafael, CA
  • NPI 1972984722
  NPD tax ID

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Gary L. Dennis, R. PH.

  • Pharmacist
  • Rohnert Park, CA
  • NPI 1043425721
  NPD (past)

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

{
    "created_epoch": "1743033600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1743033600000",
    "number": "1629871637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3299 E HILL ST STE 301",
            "city": "SIGNAL HILL",
            "state": "CA",
            "postal_code": "907551231",
            "telephone_number": "415-521-1555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "170 PROFESSIONAL CENTER DR STE C",
            "city": "ROHNERT PARK",
            "state": "CA",
            "postal_code": "949282169",
            "telephone_number": "707-953-4528"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARIN WELLNESS PHARMACY LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MARIN WELLNESS PHARMACY LLC",
        "enumeration_date": "2025-03-27",
        "last_updated": "2025-03-27",
        "certification_date": "2025-03-27",
        "status": "A",
        "authorized_official_last_name": "HAILEMARIAM",
        "authorized_official_first_name": "MOUSSIE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "707-953-4528"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3336H0001X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Home Infusion Therapy Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Apex Infusion Pharmacy Rohnert Park",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Audrey Mahlstedt, MA CCC-SLP
• Leah Mahood
• George Malkemus, DDS
• John D Mann, DDS
• Kavita Mardemootoo
• Elizabeth Marois, RN
• Jeanette Marie Marrero
• Laura Martin, M.D.
• Ronald James Martin, O.D.
• Juan Vincent Martinez Jimenez

• Community/Retail Pharmacy in Rohnert Park, CA
• Providers in Rohnert Park, 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 Mar 27, 2025; 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.

Verify at the official NPI Registry.