Organization Active NPI

New-Cal Pharmacy Inc

Doing business as Croal's Rexall Drugs

  • Community/Retail Pharmacy
  • Barstow, CA
National Provider Identifier
1821159989
Registry record updated Oct 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PHY50588 Issued in CA
Legal business name
NEW-CAL PHARMACY INC
Doing business as
Croal's Rexall Drugs
Practice address
901 E Williams St
Barstow, CA 92311-3049
Phone
(760) 256-8968
Fax
(760) 256-2653
NPI assigned
Dec 13, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2024

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

Authorized official

Name
Brahmaji Valiveti
Title
President
Phone
(760) 256-8968

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X PHY50588 CA Primary

Addresses

Primary practice location

901 E Williams St
Barstow, CA 92311-3049

Mailing address

901 E Williams St
Barstow, CA 92311-3049
Phone (760) 256-8968

Other identifiers 1

IdentifierTypeStateIssuer
2130472OtherPK

Other names 1

  • Croal's Rexall Drugs Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930029123 CA DME Supplier - Pharmacy 5991909749 Practice locations: Barstow, CA

National Provider Directory

National Provider Directory
Tax ID family
Croal's Rexall Drugs2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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": "1165968000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729036800000",
    "number": "1821159989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 E WILLIAMS ST",
            "city": "BARSTOW",
            "state": "CA",
            "postal_code": "923113049",
            "telephone_number": "760-256-8968",
            "fax_number": "760-256-2653"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 E WILLIAMS ST",
            "city": "BARSTOW",
            "state": "CA",
            "postal_code": "923113049",
            "telephone_number": "760-256-8968",
            "fax_number": "760-256-2653"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW-CAL PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-13",
        "last_updated": "2024-10-16",
        "certification_date": "2024-10-16",
        "status": "A",
        "authorized_official_last_name": "VALIVETI",
        "authorized_official_first_name": "BRAHMAJI",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "760-256-8968"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CA",
            "license": "PHY50588",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2130472",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Croal's Rexall Drugs",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Barstow, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.