Active NPI
Mark Henry
- Pharmacist
- Newbury Park, CA
National Provider Identifier
1700456787
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 84389
- Practice address
- 451 S Reino Rd
Newbury Park, CA 91320-4267 - Phone
- (805) 499-4006
- NPI assigned
- Jun 30, 2021
- Last updated
- Jun 30, 2021
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 84389 | CA | Primary |
Addresses
Primary practice location
451 S Reino Rd
Newbury Park, CA 91320-4267
Mailing address
451 S Reino Rd
Newbury Park, CA 91320-4267
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 84389 | CA | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Longs Drug Store California LLC | Past | Accepting new patients | |
| Longs Drug Stores California LLC | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba CVS Pharmacy #03069
- Community/Retail Pharmacy
- Newbury Park, CA
- NPI 1760425094
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1625011200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1625011200000",
"number": "1700456787",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "451 S REINO RD",
"city": "NEWBURY PARK",
"state": "CA",
"postal_code": "913204267"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "451 S REINO RD",
"city": "NEWBURY PARK",
"state": "CA",
"postal_code": "913204267",
"telephone_number": "805-499-4006"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HENRY",
"first_name": "MARK",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2021-06-30",
"last_updated": "2021-06-30",
"certification_date": "2021-06-30",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "84389",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Newbury Park, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.