NPIMap

Organization Active NPI

Lido Pharmacy LLC

Doing business as Pacific LTC Pharmacy

  • Long Term Care Pharmacy
  • Newport Beach, CA
National Provider Identifier
1871002485
Registry record updated Nov 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
Legal business name
LIDO PHARMACY LLC
Doing business as
Pacific LTC Pharmacy
Practice address
361 Hospital Rd Ste 425
Newport Beach, CA 92663-3525
Phone
(949) 524-3566
NPI assigned
Sep 26, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2024

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

Authorized official

Name
Stephen Thomas HomNPI 1063847523
Title
Managing Member
Phone
(760) 217-9250

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Long Term Care Pharmacy 3336L0003X Primary

Addresses

Primary practice location

361 Hospital Rd Ste 425
Newport Beach, CA 92663-3525

Mailing address

361 Hospital Rd Ste 425
Newport Beach, CA 92663-3525
Phone (949) 524-3566

Other names 1

  • Pacific LTC Pharmacy Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Pacific Pharmacy Group6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

Locations

351 Hospital Rd
Ste 207
Newport Beach, CA 92663
Phone (949) 646-2800

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1506384000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1732060800000",
    "number": "1871002485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "361 HOSPITAL RD STE 425",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926633525",
            "telephone_number": "949-524-3566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "361 HOSPITAL RD STE 425",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926633525",
            "telephone_number": "949-524-3566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIDO PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-26",
        "last_updated": "2024-11-20",
        "certification_date": "2024-11-20",
        "status": "A",
        "authorized_official_last_name": "HOM",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "THOMAS",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "760-217-9250"
    },
    "taxonomies": [
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pacific LTC Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Newport Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2024; 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.