Organization Active NPI

O'Briens Market, Inc

  • Community/Retail Pharmacy
  • Riverbank, CA
National Provider Identifier
1730114224
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PHY40628 Issued in CA
Legal business name
O'BRIENS MARKET, INC
Practice address
6331 Oakdale Rd
Riverbank, CA 95367-9646
Phone
(209) 869-9055
Fax
(209) 869-9057
NPI assigned
Jul 12, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Charles O'Brien
Title
Owner
Phone
(209) 869-9055

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X PHY40628 CA Primary

Addresses

Primary practice location

6331 Oakdale Rd
Riverbank, CA 95367-9646

Mailing address

6331 Oakdale Rd
Riverbank, CA 95367-9646
Phone (209) 869-9055

Other identifiers 1

IdentifierTypeStateIssuer
PHA406280MedicaidCA

National Provider Directory

National Provider Directory

Locations

6331 Oakdale Rd
Riverbank, CA 95367
Phone (209) 869-9055

Practitioners & affiliated clinicians

Practitioners 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1730114224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6331 OAKDALE RD",
            "city": "RIVERBANK",
            "state": "CA",
            "postal_code": "953679646",
            "telephone_number": "209-869-9055",
            "fax_number": "209-869-9057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6331 OAKDALE RD",
            "city": "RIVERBANK",
            "state": "CA",
            "postal_code": "953679646",
            "telephone_number": "209-869-9055",
            "fax_number": "209-869-9057"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "O'BRIENS MARKET, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "O'BRIEN",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "209-869-9055",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CA",
            "license": "PHY40628",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PHA406280",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverbank, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.