NPIMap

Organization Active NPI

Donald Wayne Smith

  • Community/Retail Pharmacy
  • Stockton, CA
National Provider Identifier
1891737193
Registry record updated Jul 21, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PHY43499 Issued in CA
Legal business name
DONALD WAYNE SMITH
Practice address
937 N Yosemite St
Stockton, CA 95203-2216
Phone
(209) 465-2671
Fax
(209) 465-6831
NPI assigned
Jun 12, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2008

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

Authorized official

Name
Mr. Donald Wayne Smith, RPHNPI 1568611531
Title
Owner
Phone
(209) 465-2671

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
Community/Retail Pharmacy 3336C0003X PHY43499 CA Primary

Addresses

Primary practice location

937 N Yosemite St
Stockton, CA 95203-2216

Mailing address

937 N Yosemite St
Stockton, CA 95203-2216
Phone (209) 465-2671

Other identifiers 3

IdentifierTypeStateIssuer
PHY43499OtherCASTATE LICENSE #
PHA434990MedicaidCA
0579283OtherCANAPB

Other names 1

  • Forty Nine Drug Co. Doing business as

National Provider Directory

National Provider Directory

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": "1150070400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216598400000",
    "number": "1891737193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "937 N YOSEMITE ST",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952032216",
            "telephone_number": "209-465-2671",
            "fax_number": "209-465-6831"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "937 N YOSEMITE ST",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952032216",
            "telephone_number": "209-465-2671",
            "fax_number": "209-465-6831"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DONALD WAYNE SMITH",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-12",
        "last_updated": "2008-07-21",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "WAYNE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "209-465-2671",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CA",
            "license": "PHY43499",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE #",
            "identifier": "PHY43499",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PHA434990",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NAPB",
            "identifier": "0579283",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Forty Nine Drug Co.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Stockton, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2008; 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.