Pine Drug Holdings LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

PINE DRUG HOLDINGS LLC

Practice address

1500 E Katella Ave Ste C
Orange, CA 92867-5089

Phone

(714) 912-4309

NPI assigned

Feb 14, 2022

Organization subpart

Yes

Parent organization

PINE DRUG HOLDINGS LLCAs reported in NPPES

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

Authorized official

Name

John Dang, PHARMD

Title

Ceo

Phone

(714) 922-9886

Specialties & licenses 3

Addresses

Other names 1

• ALOHA PHARMACY #3 Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Tax ID family

Pine Drug Inc2 organizations share this tax ID, including this one

Part of

Pine Drug Holdings LLC

Other organizations with this tax ID 1

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

• Pine Drug Inc

  • Community/Retail Pharmacy
  • Santa Ana, CA
  • NPI 1003201328
  NPD tax ID

Locations

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

{
    "created_epoch": "1644796800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1691971200000",
    "number": "1679228183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 E KATELLA AVE STE C",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928675089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 E KATELLA AVE STE C",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928675089",
            "telephone_number": "714-912-4309"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PINE DRUG HOLDINGS LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PINE DRUG HOLDINGS LLC",
        "enumeration_date": "2022-02-14",
        "last_updated": "2023-08-14",
        "certification_date": "2023-08-14",
        "status": "A",
        "authorized_official_last_name": "DANG",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "714-922-9886",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ALOHA PHARMACY #3",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "ALOHA PHARMACY #3",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Pin Medical Associates, PC
• Moises Pina Carballo
• Adriana Pina
• Andrea R Pincus, M.A., CCC-SLP
• David Pincus, PH.D.
• Esmeralda Pineda Rojas
• Allison D Pineda
• Christian P Pineda, MD
• Dianet Pineda
• Gabrielle Pineda

• Community/Retail Pharmacy in Orange, CA
• Providers in Orange, 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 Aug 14, 2023; 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.