Mary Botros, RPH

Primary specialty

PharmacistTaxonomy code 183500000X

License

70795 Issued in CA

Practice address

79719 Parkway Esplanade S
La Quinta, CA 92253-4090

Phone

(714) 650-2946

NPI assigned

Aug 26, 2014

Last updated

Mar 9, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Pharmacist

State licenses

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

{
    "created_epoch": "1409011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615248000000",
    "number": "1801296801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "79719 PARKWAY ESPLANADE S",
            "city": "LA QUINTA",
            "state": "CA",
            "postal_code": "922534090",
            "telephone_number": "714-650-2946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "79719 PARKWAY ESPLANADE S",
            "city": "LA QUINTA",
            "state": "CA",
            "postal_code": "922534090",
            "telephone_number": "714-650-2946"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2601 S Broadmoor Dr Apt 12",
            "address_purpose": "LOCATION",
            "city": "Palm Springs",
            "state": "CA",
            "postal_code": "922645904",
            "country_code": "US",
            "telephone_number": "714-650-2946",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOTROS",
        "first_name": "MARY",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-08-26",
        "last_updated": "2021-03-09",
        "certification_date": "2021-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "70795",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "marysamuel2009live.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "walgreens",
            "address_1": "79719 Parkway Esplanade S",
            "city": "LA Quinta",
            "state": "CA",
            "country_code": "US",
            "postal_code": "922534090",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Pharmacist in La Quinta, CA
• Providers in La Quinta, CA by specialty
• Pharmacist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2021; 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.