Raul's Vineland Pharmacy

Primary specialty

PharmacistTaxonomy code 183500000X

License

PHY37601 Issued in CA

Legal business name

RAUL'S VINELAND PHARMACY

Practice address

11717 Saticoy St
North Hollywood, CA 91605-2833

Phone

(818) 982-7825

Fax

(818) 982-7827

NPI assigned

Oct 4, 2005

Organization subpart

No

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

Authorized official

Name

Mr. Raul Antonio Mercurio, ETC

Title

Owner

Phone

(818) 982-7825

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1128384000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213574400000",
    "number": "1902893852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11717 SATICOY ST",
            "city": "NORTH HOLLYWOOD",
            "state": "CA",
            "postal_code": "916052833",
            "telephone_number": "818-982-7825",
            "fax_number": "818-982-7827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11717 SATICOY ST",
            "city": "NORTH HOLLYWOOD",
            "state": "CA",
            "postal_code": "916052833",
            "telephone_number": "818-982-7825",
            "fax_number": "818-982-7827"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RAUL'S VINELAND PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-04",
        "last_updated": "2008-06-16",
        "status": "A",
        "authorized_official_last_name": "MERCURIO",
        "authorized_official_first_name": "RAUL",
        "authorized_official_middle_name": "ANTONIO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "818-982-7825",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "ETC"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "PHY37601",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NABP",
            "identifier": "0579461",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Pharmacist in North Hollywood, CA
• Providers in North Hollywood, CA by specialty
• Pharmacist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 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.