NPIMap

Organization Active NPI

Riteaid 5614

  • Community/Retail Pharmacy
  • Chula Vista, CA
National Provider Identifier
1730202425
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
42230 Issued in CA
Legal business name
RITEAID 5614
Practice address
740 Otay Lakes Rd
Chula Vista, CA 91910-6915
Phone
(619) 421-4872
Fax
(619) 421-2452
NPI assigned
Apr 9, 2007
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
Dr. Pedro Miguel Sousa, PHARM.D.
Title
Pharmacy Manager
Phone
(619) 421-4872

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 42230 CA Primary

Addresses

Primary practice location

740 Otay Lakes Rd
Chula Vista, CA 91910-6915

Mailing address

740 Otay Lakes Rd
Chula Vista, CA 92104-6915
Phone (619) 421-4872

National Provider Directory

National Provider Directory
Tax ID family
Rite Aid Specialty Pharmacy LLC49 organizations share this tax ID, including this one

Other organizations with this tax ID 48

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

View all 48

Locations

740 Otay Lakes Rd
Chula Vista, CA 91910
Phone (619) 421-4872

NPI Registry JSON

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

{
    "created_epoch": "1176076800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1730202425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "740 OTAY LAKES RD",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "921046915",
            "telephone_number": "619-421-4872",
            "fax_number": "619-421-2452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "740 OTAY LAKES RD",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919106915",
            "telephone_number": "619-421-4872",
            "fax_number": "619-421-2452"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RITEAID 5614",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SOUSA",
        "authorized_official_first_name": "PEDRO",
        "authorized_official_middle_name": "MIGUEL",
        "authorized_official_title_or_position": "PHARMACY MANAGER",
        "authorized_official_telephone_number": "619-421-4872",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHARM.D."
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CA",
            "license": "42230",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chula Vista, 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.