NPIMap

Organization Active NPI

Elephant Pharmacy Operating Corp

  • Pharmacist
  • Berkeley, CA
National Provider Identifier
1740276286
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
RPH50642 Issued in CA
Legal business name
ELEPHANT PHARMACY OPERATING CORP
Practice address
1607 Shattuck Ave
Berkeley, CA 94709-1611
Phone
(510) 549-9201
Fax
(510) 549-9204
NPI assigned
Sep 20, 2005
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
Terry Cater, R.PH.
Title
VP of Pharmacy
Phone
(510) 549-9201

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PharmacistGroup: 193400000X SINGLE SPECIALTY GROUP 183500000X RPH50642 CA Primary

Addresses

Primary practice location

1607 Shattuck Ave
Berkeley, CA 94709-1611

Mailing address

1607 Shattuck Ave
Berkeley, CA 94709-1611
Phone (510) 549-9201

Other identifiers 1

IdentifierTypeStateIssuer
PHA460850MedicaidCA

National Provider Directory

National Provider Directory
Tax ID family
Elephant Pharmacy Operating Corp3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

NPI Registry JSON

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

{
    "created_epoch": "1127174400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1740276286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1607 SHATTUCK AVE",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947091611",
            "telephone_number": "510-549-9201",
            "fax_number": "510-549-9204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1607 SHATTUCK AVE",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947091611",
            "telephone_number": "510-549-9201",
            "fax_number": "510-549-9204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELEPHANT PHARMACY OPERATING CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CATER",
        "authorized_official_first_name": "TERRY",
        "authorized_official_title_or_position": "VP OF PHARMACY",
        "authorized_official_telephone_number": "510-549-9201",
        "authorized_official_credential": "R.PH."
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "RPH50642",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PHA460850",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Berkeley, 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.