Amena Pharmacy Corp

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PHY55952 Issued in CA

Legal business name

AMENA PHARMACY CORP

Doing business as

HEALTHCARE PHARMACy

Practice address

14642 Newport Ave
Tustin, CA 92780-6057

Phone

(714) 669-4000

Fax

(714) 669-4484

NPI assigned

Feb 7, 2007

Last updated

Jul 19, 2018By 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

Fareed Entezar, PHARMDNPI 1619443835

Title

Pharmacist in Charge

Phone

(714) 669-4000

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• HEALTHCARE PHARMACy Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

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

Locations

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.

• Fareed Entezar

  • Pharmacist
  • Tustin, CA
  • NPI 1619443835
  NPD Authorized official

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

{
    "created_epoch": "1170806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1531958400000",
    "number": "1679613111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14642 NEWPORT AVE",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927806057",
            "telephone_number": "714-669-4000",
            "fax_number": "714-669-4484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14642 NEWPORT AVE",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927806057",
            "telephone_number": "714-669-4000",
            "fax_number": "714-669-4484"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMENA PHARMACY CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-07",
        "last_updated": "2018-07-19",
        "status": "A",
        "authorized_official_last_name": "ENTEZAR",
        "authorized_official_first_name": "FAREED",
        "authorized_official_title_or_position": "PHARMACIST IN CHARGE",
        "authorized_official_telephone_number": "714-669-4000",
        "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": "CA",
            "license": "PHY55952",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "1999991",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HEALTHCARE PHARMACy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Amanda Rafi, DMD Apdc (Rafi Dental Group)
• Amanda Rafi, DMD Apdc (Rafi Dental Group)
• Angel Amaro
• Amd Transport
• Amelia Ramirez Orduna DDS Inc (Tustin Dental)
• Chamith Ameresekere, DC
• American Surgical Medical Supply Inc (American Surgical Medical Supply Tustin)
• Americana Health Facility Inc (Americana Health Center)
• Ameridenti LLC
• Caterina Irene Amici

• Community/Retail Pharmacy in Tustin, CA
• Providers in Tustin, 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 Jul 19, 2018; 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.