Active NPI
Mission Wellness Healthcare LLC
- Long Term Care Pharmacy
- San Francisco, CA
National Provider Identifier
1740809219
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Long Term Care Pharmacy
- Legal business name
- MISSION WELLNESS HEALTHCARE LLC
- Practice address
- 2424 Mission St
San Francisco, CA 94110-2415 - Phone
- (415) 826-3484
- Fax
- (415) 826-7077
- NPI assigned
- Apr 14, 2020
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Daniel Andrzejek
- Title
- Ceo
- Phone
- (415) 577-4743
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Long Term Care Pharmacy | 3336L0003X | Primary |
Addresses
Primary practice location
2424 Mission St
San Francisco, CA 94110-2415
Mailing address
PO Box 7775 #52191
San Francisco, CA 94120
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518394857 | Medicaid | CA |
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1586822400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1586822400000",
"number": "1740809219",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 7775 #52191",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "94120"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2424 MISSION ST",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "941102415",
"telephone_number": "415-826-3484",
"fax_number": "415-826-7077"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MISSION WELLNESS HEALTHCARE LLC",
"organizational_subpart": "NO",
"enumeration_date": "2020-04-14",
"last_updated": "2020-04-14",
"certification_date": "2020-04-14",
"status": "A",
"authorized_official_last_name": "ANDRZEJEK",
"authorized_official_first_name": "DANIEL",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "415-577-4743"
},
"taxonomies": [
{
"code": "3336L0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Long Term Care Pharmacy",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1518394857",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in San Francisco, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 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.