The Camarillo Pharmacy Inc

Primary specialty

PharmacyTaxonomy code 333600000X

Legal business name

THE CAMARILLO PHARMACY INC

Doing business as

MEDICINE SHOPPE

Practice address

2173 Pickwick Dr
Camarillo, CA 93010-6426

Phone

(805) 389-5311

Fax

(805) 389-5309

NPI assigned

Nov 15, 2006

Reactivated

May 30, 2008

Organization subpart

No

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

Authorized official

Name

Dena Ferman

Title

Third Party Plan Coordinator

Phone

(314) 993-6000

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• MEDICINE SHOPPE Doing business as

Locations

Practitioners 1

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

• Sung Il Lee, PHARM.D.

  • Pharmacist
  • Camarillo, CA
  • NPI 1154529758
  NPD (past)

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

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1710059597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2173 PICKWICK DR",
            "city": "CAMARILLO",
            "state": "CA",
            "postal_code": "930106426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2173 PICKWICK DR",
            "city": "CAMARILLO",
            "state": "CA",
            "postal_code": "930106426",
            "telephone_number": "805-389-5311",
            "fax_number": "805-389-5309"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE CAMARILLO PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-15",
        "last_updated": "2023-03-07",
        "deactivation_date": "2008-04-30",
        "reactivation_date": "2008-05-30",
        "status": "A",
        "authorized_official_last_name": "FERMAN",
        "authorized_official_first_name": "DENA",
        "authorized_official_title_or_position": "THIRD PARTY PLAN COORDINATOR",
        "authorized_official_telephone_number": "314-993-6000"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER COMMERCIAL NUMBER",
            "identifier": "0537449",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PHA462420",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MEDICINE SHOPPE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Wendy Testa, MA
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• Kaitlyn Tevis
• Lacie Thacker
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• The Wilgus & Hunter Business Partnership
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• Kaitlyn Thibodeau

• Pharmacy in Camarillo, CA
• Providers in Camarillo, CA by specialty
• Pharmacy in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.